Cooper, Mary E

Cooper, Mary E is an individual health care provider with primary practice located at 1000 Eddy Street , Providence RI 02905. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Cooper, Mary E can be contacted via phone (401) 533-9100.

Contact Information

Primary practice address
1000 Eddy Street Providence RI 02905
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1669492765
LBN Legal business name Cooper, Mary E
Credentials MS PHYSICAL EDU
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669492765 NPPES
Rhode Island MEDICAID 9009994
Rhode Island MEDICAID 99947
Rhode Island MEDICAID 2058
Rhode Island Other 6400144

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