Malik N Cobb Sr., PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00020400 Issued in NJ

Practice address

65 Bergen St
Suite Ga-230
Newark, NJ 07107-3001

Phone

(973) 972-9461

Fax

(973) 972-6227

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043420045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EASTWOOD DR",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085204745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BERGEN ST",
            "address_2": "SUITE GA-230",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073001",
            "telephone_number": "973-972-9461",
            "fax_number": "973-972-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "MALIK",
        "middle_name": "N",
        "name_suffix": "Sr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00020400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Bruce Cleveland, D.D.S.
• Clinical Practice PC
• Clinton Hill Dental Assoc
• Tobechukwu Clouden, MD
• CM Solutions LLC
• Katiria Cobian
• Colleen Elizabeth Cocca
• Levi Coelho Maia Barros, MD
• Kimberly Coelho-Vera, LPC
• Marlon Daniel Gomes Coelho, MD

• Surgical Physician Assistant in Newark, NJ
• Providers in Newark, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.