Provider Demographics
NPI:1124225222
Name:COOKE, ARYIAN LURECIA (MD)
Entity Type:Individual
Prefix:
First Name:ARYIAN
Middle Name:LURECIA
Last Name:COOKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARYIAN
Other - Middle Name:LURECIA
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-0100
Mailing Address - Country:US
Mailing Address - Phone:240-252-2140
Mailing Address - Fax:240-252-2141
Practice Address - Street 1:4470 REGENCY PL
Practice Address - Street 2:SUITE 106
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3085
Practice Address - Country:US
Practice Address - Phone:240-252-2140
Practice Address - Fax:240-252-2141
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066210207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD203335600Medicaid
MD413168100Medicaid
MD413168100Medicaid