Individual
EILEEN MARY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-3600
Mailing address
5813 N BURDICK ST, EAST SYRACUSE, NY 13057-9546
(315) 663-6464
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402445
NY
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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