Provider Demographics
NPI:1780949206
Name:COOK, KATHERINE LEE
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:LEE
Last Name:COOK
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 1:50 E 8TH ST
Mailing Address - Street 2:APT. 2X
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6502
Mailing Address - Country:US
Mailing Address - Phone:631-871-6119
Mailing Address - Fax:
Practice Address - Street 1:50 E 8TH ST
Practice Address - Street 2:APT. 2X
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6502
Practice Address - Country:US
Practice Address - Phone:631-871-6119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist