Basic Information
| Provider Information | |||||||||
| NPI: | 1417136276 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | ALYSSA | ||||||||
| MiddleName: | FLANAGAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FLANAGAN | ||||||||
| OtherFirstName: | ALYSSA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1000 E. EAGER ST. | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105229800 | ||||||||
| FaxNumber: | 4103672714 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E. EAGER ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105229800 | ||||||||
| FaxNumber: | 4103672714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2007 | ||||||||
| LastUpdateDate: | 03/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036.123141 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 036.123141 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | D0076411 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | D0076411 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.