Provider Demographics
NPI:1033211495
Name:COONEY, JOSEPH O (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:O
Last Name:COONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-0238
Mailing Address - Country:US
Mailing Address - Phone:413-298-3700
Mailing Address - Fax:413-298-3172
Practice Address - Street 1:8 PINE ST
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262-9706
Practice Address - Country:US
Practice Address - Phone:413-298-3700
Practice Address - Fax:413-298-3172
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA35950Medicare ID - Type Unspecified
MAA35950Medicare PIN
MAH93080Medicare UPIN
MAA35950Medicare Oscar/Certification