Individual
CARL COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
265 BROADHOLLOW RD STE 200, MELVILLE, NY 11747-4833
(516) 710-8271
Mailing address
265 BROADHOLLOW RD STE 200, MELVILLE, NY 11747-4833
(516) 710-8271
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
333276
NY
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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