Individual ProviderKathleen K CooperNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address450 Clarkson Ave # 22, Brooklyn, NY 11203-2012(631) 734-8286(631) 574-2580PECOS EnrollmentBased on the most recent information from CMS, provider Kathleen K Cooper does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1558635482Provider TypeIndividualFull NameCooper, Kathleen KCredentialFNPGenderFemaleSole ProprietorYesEnumeration Date2/23/2012Last Updated11/19/2015Contact InformationPractice LocationPractice Address450 Clarkson Ave # 22, Brooklyn, NY 11203-2012Phone(631) 734-8286Fax(631) 734-8286Mailing LocationMailing Address1869 Brentwood Rd, Brentwood, NY 11717-4625Phone(631) 574-2580Fax(631) 574-2585Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense33 330164NYNew York