Provider Demographics
NPI:1700761129
Name:COOPER, DAHLIA PATRICA II
Entity type:Individual
Prefix:MISS
First Name:DAHLIA
Middle Name:PATRICA
Last Name:COOPER
Suffix:II
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 1:1266 LIBERTY AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2035
Mailing Address - Country:US
Mailing Address - Phone:862-235-6261
Mailing Address - Fax:
Practice Address - Street 1:1266 LIBERTY AVE FL 3
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2035
Practice Address - Country:US
Practice Address - Phone:862-235-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NH18480100163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health