Provider Demographics
NPI:1912579764
Name:COOKE, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2911
Mailing Address - Country:US
Mailing Address - Phone:716-440-0379
Mailing Address - Fax:
Practice Address - Street 1:50 FOUNTAIN PLZ STE 1400
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-2215
Practice Address - Country:US
Practice Address - Phone:716-381-6315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist