Provider Demographics
NPI:1992941652
Name:COOK, HEATHER CHRISTINE (RPAC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:COOK
Suffix:
Gender:F
Credentials:RPAC
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Mailing Address - Street 1:NEW YORK SPINE & BRAIN SURGERY
Mailing Address - Street 2:HSC T12 RM 080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8122
Mailing Address - Country:US
Mailing Address - Phone:631-444-8070
Mailing Address - Fax:631-444-1535
Practice Address - Street 1:NEW YORK SPINE & BRAIN SURGERY
Practice Address - Street 2:HSC T12 RM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8122
Practice Address - Country:US
Practice Address - Phone:631-444-8070
Practice Address - Fax:631-444-1535
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY012874363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant