Individual
MS. LACI NICOLE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
270 UNION AVE, HOLBROOK, NY 11741-1823
(631) 588-4442
Mailing address
91 BEECH ST, LAKE GROVE, NY 11755-3145
(917) 748-5073
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20142655
NY
Other
Enumeration date
03/05/2015
Last updated
04/08/2015
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