Cooper, Bruce
Cooper, Bruce is an individual health care provider with primary practice located at 22 W Main St , Niantic CT 06357-2340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Cooper, Bruce can be contacted via phone (860) 739-4431.Contact Information
Primary practice address
22 W Main St
Niantic CT 06357-2340
Phone: (860) 739-4431
Fax: (860) 739-9461
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24339 | Connecticut |
Profile Details
| NPI number | 1043203037 |
|---|---|
| LBN Legal business name | Cooper, Bruce |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2005 |
| Last updated | Dec 1st, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043203037 | NPPES |
| Connecticut | Other | 030023 | HEALTHNET |
| Connecticut | MEDICAID | 1243393 | HEALTHNET |
| Connecticut | Other | 010024339CT01 | HEALTHNET |
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