Provider Demographics
NPI:1386294866
Name:COOKE, ELIZABETH MURPHY
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MURPHY
Last Name:COOKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 GLEN COVE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1432
Mailing Address - Country:US
Mailing Address - Phone:310-804-3220
Mailing Address - Fax:
Practice Address - Street 1:521 GLEN COVE AVE
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-1432
Practice Address - Country:US
Practice Address - Phone:310-804-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program