Provider Demographics
NPI:1265546766
Name:COONEY, THOMAS ANDREW (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANDREW
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 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3466
Mailing Address - Country:US
Mailing Address - Phone:510-625-5356
Mailing Address - Fax:877-738-4262
Practice Address - Street 1:1938 PEACHTREE RD NW
Practice Address - Street 2:SUITE 205
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1267
Practice Address - Country:US
Practice Address - Phone:585-275-4912
Practice Address - Fax:585-276-2144
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251212207R00000X, 208M00000X
GA064523208M00000X
CAC156143208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400003999Medicare PIN