Provider Demographics
NPI:1437226644
Name:COOPER, PATRICIA JOAN (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JOAN
Last Name:COOPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JOAN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:NY HOSPITAL MEDICAL CENTER OF QUEENS
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-670-1426
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:NY HOSPITAL MEDICAL CENTER OF QUEENS
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1426
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381254363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6383WQMedicare ID - Type Unspecified
P01825Medicare UPIN