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Individual

KEITH D. COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
140 BERGEN ST, LEVEL E, NEWARK, NJ 07103-2425
(973) 972-8320
(973) 972-3162
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00254100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9036903
NJ
Enumeration date
08/18/2006
Last updated
05/31/2022
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