MEDICARE: MAUREEN COONEY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	193032	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528131232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN COONEY DO

Provider Business Mailing Address
First Line	:	311 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1627
Country	:	US
Telephone Number	:	845-358-5437
Fax Number	:	845-512-8440

Provider Business Practice Location Address
First Line	:	311 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1627
Country	:	US
Telephone Number	:	845-358-5437
Fax Number	:	845-512-8440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	09/15/2016

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Directions to “ MAUREEN COONEY DO” Practice Location

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