Provider Demographics
NPI:1750405528
Name:COOK, CYNTHIA L (NP)
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:L
Last Name:COOK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:38 SCHALREN DR
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1226
Mailing Address - Country:US
Mailing Address - Phone:518-783-7667
Mailing Address - Fax:
Practice Address - Street 1:930 ALBANY SHAKER RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-6412
Practice Address - Country:US
Practice Address - Phone:518-220-9413
Practice Address - Fax:518-220-9417
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health