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1225268360
ICEYLEEN COOPER
ASTORIA, NY
NPI
1225268360
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 009579)
Enumeration Date
2009-07-23
Last Update Date
2009-07-23
Business Address
-- ICEYLEEN COOPER RPA
4904 19TH AVE
ASTORIA, NY 11105-1002
Phone number: 718-777-3494
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Mailing Address
-- ICEYLEEN COOPER RPA
4904 19TH AVE
ASTORIA, NY 11105-1002
Phone number: 718-777-3494
Copy
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