Cooper, Kenneth

Cooper, Kenneth is an individual health care provider with primary practice located at 739 Irving Ave Suite 450, Syracuse NY 13210-1651. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Cooper, Kenneth can be contacted via phone (315) 470-7364.

Contact Information

Primary practice address
739 Irving Ave Suite 450 Syracuse NY 13210-1651
Phone: (315) 470-7364
Fax: (315) 470-5859
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 244186 New York

Profile Details

NPI number 1518166289
LBN Legal business name Cooper, Kenneth
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2007
Last updated Apr 9th, 2021 - about 5 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 1518166289 NPPES
New York MEDICAID 02901417

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