Cooper, Ellen R

Cooper, Ellen R is an individual health care provider with primary practice located at 850 Harrison Ave Yacc5, Boston MA 02118-4001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases, which is considered as her primary health care specialty. Cooper, Ellen R can be contacted via phone (617) 414-4841.

Contact Information

Primary practice address
850 Harrison Ave Yacc5 Boston MA 02118-4001
Phone: (617) 414-4841
Fax: (617) 414-7230
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X 56270 Massachusetts

Profile Details

NPI number 1912998675
LBN Legal business name Cooper, Ellen R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated May 9th, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912998675 NPPES
Massachusetts MEDICAID 110043103A

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