Individual
KEVIN CHARLES COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-2100
Mailing address
83 DURAND DR, ROCHESTER, NY 14622-1232
(315) 558-1556
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
431186
NY
363L00000X
Nurse Practitioner
431186
NY
Other
Enumeration date
09/27/2017
Last updated
06/29/2023
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