Provider Demographics
NPI:1427313501
Name:WAKEFIELD COOKE, ARLENE GRACE (ED)
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:GRACE
Last Name:WAKEFIELD COOKE
Suffix:
Gender:F
Credentials:ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PINELAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1917
Mailing Address - Country:US
Mailing Address - Phone:631-774-3226
Mailing Address - Fax:
Practice Address - Street 1:253 W 35TH ST FL 16
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1907
Practice Address - Country:US
Practice Address - Phone:718-728-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY822558174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist