Provider Demographics
NPI:1588647705
Name:COONEY, ELIZABETH L (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:COONEY
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9805
Mailing Address - Street 2:300 GEORGE STREET 6TH FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06536-0805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:789 HOWARD AVE
Practice Address - Street 2:DANA BUILDING - 3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-785-4629
Practice Address - Fax:203-785-3588
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2008-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT031840207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001318402Medicaid
CT440000060Medicare ID - Type Unspecified
E85075Medicare UPIN