Provider Demographics
NPI:1518206762
Name:COOPER, LOUISE MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:MARIE
Last Name:COOPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 KAPOOR HALL
Mailing Address - Street 2:UNIVERISTY AT BUFFALO
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-8033
Mailing Address - Country:US
Mailing Address - Phone:716-645-4806
Mailing Address - Fax:716-829-6094
Practice Address - Street 1:3435 MAIN ST
Practice Address - Street 2:242 KAPOOR HALL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-3001
Practice Address - Country:US
Practice Address - Phone:716-645-4806
Practice Address - Fax:716-829-6094
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027020-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027020-1OtherPHARMACIST LICENSE NUMBER