Provider Demographics
NPI:1255124384
Name:COOK-WHITE, SUSAN R
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:R
Last Name:COOK-WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SUZY
Other - Middle Name:R
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLC
Mailing Address - Street 1:940 LITTLE BARDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8932
Mailing Address - Country:US
Mailing Address - Phone:585-350-6235
Mailing Address - Fax:
Practice Address - Street 1:940 LITTLE BARDFIELD RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-8932
Practice Address - Country:US
Practice Address - Phone:585-350-6235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty