Provider Demographics
NPI:1356063168
Name:COOK, BRAHEM BERNARD I
Entity type:Individual
Prefix:MR
First Name:BRAHEM
Middle Name:BERNARD
Last Name:COOK
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3927 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2063
Mailing Address - Country:US
Mailing Address - Phone:240-828-9326
Mailing Address - Fax:
Practice Address - Street 1:3927 WARNER AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2063
Practice Address - Country:US
Practice Address - Phone:240-828-9326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant