Provider Demographics
NPI:1740453174
Name:COONEY, CORNELIUS MARY (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:CORNELIUS
Middle Name:MARY
Last Name:COONEY
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 NUTLEY LANE
Mailing Address - Street 2:DONNYBROOK
Mailing Address - City:DUBLIN
Mailing Address - State:DUBLIN
Mailing Address - Zip Code:4
Mailing Address - Country:IE
Mailing Address - Phone:3531-269-7873
Mailing Address - Fax:
Practice Address - Street 1:73 NUTLEY LANE
Practice Address - Street 2:DONNYBROOK
Practice Address - City:DUBLIN
Practice Address - State:DUBLIN
Practice Address - Zip Code:4
Practice Address - Country:IE
Practice Address - Phone:3531-269-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT272521-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology