Provider Demographics
NPI:1861107104
Name:COONEY, ELIZA
Entity type:Individual
Prefix:
First Name:ELIZA
Middle Name:
Last Name:COONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01096-9702
Mailing Address - Country:US
Mailing Address - Phone:413-768-9303
Mailing Address - Fax:
Practice Address - Street 1:2 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MA
Practice Address - Zip Code:01096-9702
Practice Address - Country:US
Practice Address - Phone:413-768-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide