Provider Demographics
NPI:1336139294
Name:COOPER, CYNTHIA S (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:S
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15 OLD ROLLINSFORD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2868
Mailing Address - Country:US
Mailing Address - Phone:603-749-4963
Mailing Address - Fax:603-742-7094
Practice Address - Street 1:15 OLD ROLLINSFORD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2868
Practice Address - Country:US
Practice Address - Phone:603-749-4963
Practice Address - Fax:603-742-7094
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH6941207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078791Medicaid
ME1336139294Medicaid
ME1336139294Medicaid
NHC66299Medicare UPIN