Provider Demographics
NPI:1992089213
Name:COOKE, SONIA ANITA (LPN)
Entity type:Individual
Prefix:MISS
First Name:SONIA
Middle Name:ANITA
Last Name:COOKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 LAFAYETTE AVE
Mailing Address - Street 2:PH
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-6703
Mailing Address - Country:US
Mailing Address - Phone:914-788-5062
Mailing Address - Fax:
Practice Address - Street 1:291 LAFAYETTE AVE
Practice Address - Street 2:PH
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-6703
Practice Address - Country:US
Practice Address - Phone:914-788-5062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306293-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse