Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 2328 | MA |
N | 222Z00000X | Podiatrist | 2328 | MA |
N | 213EP0504X | Public Medicine | 2328 | MA |
N | 213EP1101X | Primary Podiatric Medicine | 2328 | MA |
N | 111NR0200X | Radiology | 2328 | MA |
N | 213ER0200X | Radiology | 2328 | MA |
N | 2081S0010X | Sports Medicine | 2328 | MA |
N | 213ES0000X | Sports Medicine | 2328 | MA |
Y | 213ES0103X | Foot & Ankle Surgery | 2328 | MA |
N | 213ES0131X | Foot Surgery | 2328 | MA |
NPI | 1023221082 |
---|---|
Provider Name | Dr. Jeremy Joseph Cook |
First Address | Cambridge, MA 02138-1040 |
Second Address | Cambridge, MA 02138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 05/10/2012 |