Individual
JEFFREY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 MERCER ST, NEW YORK, NY 10012-1502
(212) 677-3400
Mailing address
190 MERCER ST, NEW YORK, NY 10012-1502
(212) 677-3400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24365
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2997148
—
NY
Enumeration date
12/10/2015
Last updated
12/10/2015
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