Provider Demographics
NPI:1538320536
Name:MCGRATH, SOOK K (NP)
Entity Type:Individual
Prefix:
First Name:SOOK
Middle Name:K
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 STATE RT 208
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2406
Mailing Address - Country:US
Mailing Address - Phone:201-410-0565
Mailing Address - Fax:201-445-3452
Practice Address - Street 1:230 E RIDGEWOOD AVE BLDG 11-3
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4142
Practice Address - Country:US
Practice Address - Phone:201-967-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300165363LP2300X
NJ26NJ00072200363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00072200OtherCDS REGISTRATION
NY1538320536OtherNATIONAL PROVIDER IDENTIFICATION