Basic Information
| Provider Information | |||||||||
| NPI: | 1982040887 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COONS | ||||||||
| FirstName: | CINDY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 59 MOUNTAIN VIEW RD | ||||||||
| Address2: | |||||||||
| City: | NASSAU | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121233715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183692094 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11835 RT 9W | ||||||||
| Address2: | |||||||||
| City: | WEST COXSACKIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121923605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187319000 | ||||||||
| FaxNumber: | 5187319119 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2013 | ||||||||
| LastUpdateDate: | 11/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 016700 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.