Provider Demographics
NPI:1174214167
Name:COOK, MARGARET (LMT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ERWIN ST
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3202
Mailing Address - Country:US
Mailing Address - Phone:631-806-9182
Mailing Address - Fax:
Practice Address - Street 1:4875 SUNRISE HWY STE 302
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-4630
Practice Address - Country:US
Practice Address - Phone:631-343-4184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020007225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist