Provider Demographics
NPI:1922155787
Name:COOK, MAUREEN P (MSN CPNP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:P
Last Name:COOK
Suffix:
Gender:F
Credentials:MSN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 PROSPECT AVENUE
Mailing Address - Street 2:PEDIATRIC SPECIALTIES, PA
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-342-4001
Mailing Address - Fax:201-342-9569
Practice Address - Street 1:90 PROSPECT AVENUE
Practice Address - Street 2:PEDIATRIC
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-342-4001
Practice Address - Fax:201-342-9569
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381683363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner