Provider Demographics
NPI:1285028522
Name:COONEY, HOLLY (NP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:COONEY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:55 WATER ST
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:70 CHARLES LINDBERGH BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3634
Practice Address - Country:US
Practice Address - Phone:516-483-2020
Practice Address - Fax:516-560-1855
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2022-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY338882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400161256Medicare PIN