Cook, Keith D.

Cook, Keith D. is an individual health care provider with primary practice located at 140 Bergen St Level E, Newark NJ 07103-2425. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Cook, Keith D. can be contacted via phone (973) 972-8320.

Contact Information

Primary practice address
140 Bergen St Level E Newark NJ 07103-2425
Fax: (973) 972-3162
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 25MD00254100 New Jersey

Profile Details

NPI number 1235243106
LBN Legal business name Cook, Keith D.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated May 31st, 2022 - about 2 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 1235243106 NPPES
New Jersey MEDICAID 9036903

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