Provider Demographics
NPI:1275584344
Name:COOK, SEAN M (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:328 GREENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-2200
Mailing Address - Country:US
Mailing Address - Phone:732-356-0266
Mailing Address - Fax:732-356-5022
Practice Address - Street 1:328 GREENBROOK RD
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-2200
Practice Address - Country:US
Practice Address - Phone:732-356-0266
Practice Address - Fax:732-356-5022
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2021-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07394400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH85978Medicare UPIN