Provider Demographics
NPI:1205460524
Name:COOPER, YASMIN EL-HIFNAWI (MSED)
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:EL-HIFNAWI
Last Name:COOPER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:YASMIN
Other - Middle Name:
Other - Last Name:EL-HIFNAWI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:2572 FREDERICK DOUGLASS BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2106
Mailing Address - Country:US
Mailing Address - Phone:917-821-7290
Mailing Address - Fax:
Practice Address - Street 1:2572 FREDERICK DOUGLASS BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2106
Practice Address - Country:US
Practice Address - Phone:917-821-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250803031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty