Provider Demographics
NPI:1598065013
Name:COOK, ERIN EILEEN (PA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:EILEEN
Last Name:COOK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:R20
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-4441
Mailing Address - Country:US
Mailing Address - Phone:216-444-0406
Mailing Address - Fax:216-445-7771
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:R20
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-4441
Practice Address - Country:US
Practice Address - Phone:216-444-0406
Practice Address - Fax:216-445-7771
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003173363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical