Provider Demographics
NPI:1750428330
Name:COOK-PISCOPO, CAROL E (RPT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:COOK-PISCOPO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KIMBALL DR
Mailing Address - Street 2:SUITE 128
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2603
Mailing Address - Country:US
Mailing Address - Phone:603-836-4464
Mailing Address - Fax:603-836-4501
Practice Address - Street 1:11 KIMBALL DR
Practice Address - Street 2:SUITE 128
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2603
Practice Address - Country:US
Practice Address - Phone:603-836-4464
Practice Address - Fax:603-836-4501
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH2178Medicare ID - Type Unspecified