Provider Demographics
NPI:1629586854
Name:COOK, KRISTIN N (SEIT TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:N
Last Name:COOK
Suffix:
Gender:F
Credentials:SEIT TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 SAINT BONIFACE RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4618
Mailing Address - Country:US
Mailing Address - Phone:716-462-0117
Mailing Address - Fax:
Practice Address - Street 1:78 SAINT BONIFACE RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4618
Practice Address - Country:US
Practice Address - Phone:716-462-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist