Individual
DR. CHARLES L. COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6243 WOODHAVEN BLVD, REGO PARK, NY 11374-3731
(718) 507-4700
Mailing address
6243 WOODHAVEN BLVD, REGO PARK, NY 11374-3731
(718) 507-4700
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
161780
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00967868
—
NY
Enumeration date
07/28/2005
Last updated
09/18/2013
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