Individual provider Active NPI

Gail Franka Puckerin-Cooper, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1790822708
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071671 Issued in NY
Practice address
41 E 11TH St FL 4
New York, NY 10003
Phone
(347) 307-6262
Fax
(212) 477-2040
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 071671 NY Primary

Addresses

Primary practice location

41 E 11TH St FL 4
New York, NY 10003

Mailing address

19838 Pompeii Ave Apt 1D
Hollis, NY 11423-1422
Phone (347) 307-6262

Other practice location 1

11515 Sutphin Blvd
Jamaica, NY 11434-1020
Phone (718) 659-4000 ext. 211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1790822708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19838 POMPEII AVE APT 1D",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231422",
            "telephone_number": "347-307-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E 11TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "347-307-6262",
            "fax_number": "212-477-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11515 Sutphin Blvd",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114341020",
            "country_code": "US",
            "telephone_number": "718-659-4000 x211",
            "fax_number": "718-659-1405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCKERIN-COOPER",
        "first_name": "GAIL",
        "middle_name": "FRANKA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.