Provider Demographics
NPI:1710990346
Name:COOK-BOLDEN, FRAN E (MD)
Entity Type:Individual
Prefix:MS
First Name:FRAN
Middle Name:E
Last Name:COOK-BOLDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:150 E 58TH ST
Mailing Address - Street 2:3RD FLOOR ANNEX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10155-0002
Mailing Address - Country:US
Mailing Address - Phone:212-223-6599
Mailing Address - Fax:212-223-6598
Practice Address - Street 1:150 E 58TH ST
Practice Address - Street 2:3RD FLOOR ANNEX
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10155-0002
Practice Address - Country:US
Practice Address - Phone:212-223-6599
Practice Address - Fax:212-223-6598
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY181672207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2K4692Medicare PIN