Individual
KATHRYN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
739 IRVING AVE STE 500, SYRACUSE, NY 13210-1664
(315) 470-7409
Mailing address
1001 W FAYETTE ST STE 400, SYRACUSE, NY 13204-2866
(315) 937-3433
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
F331842
NY
363LA2200X
Adult Health Nurse Practitioner
F331842
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02054626
—
NY
Enumeration date
09/27/2005
Last updated
08/14/2024
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