1841274370 NPI number — WILLARD H COOK MD

Table of content: WILLARD H COOK MD (NPI 1841274370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841274370 NPI number — WILLARD H COOK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
WILLARD
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841274370
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8519
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED BANK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-460-9840
Provider Business Mailing Address Fax Number:
732-460-9848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
59 AVE AT THE COMMON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHREWSBURY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07702-4806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-542-7010
Provider Business Practice Location Address Fax Number:
732-542-0991
Provider Enumeration Date:
11/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0K4752 . This is a "HEALTH NET OF THE NORTHEA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4093671 . This is a "AETNA TRADITIONAL PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: MP181 . This is a "OXFORD HEALTH PLANS (NJ)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2936305 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45915 . This is a "AETNA HEALTH CAPITATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 953401 . This is a "EMPIRE BC/BS OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3530861 . This is a "CIGNA HEALTHCARE OF NJ" identifier . This identifiers is of the category "OTHER".
  • Identifier: 48262 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 342855 . This is a "UNITED HEALTHCARE INS COM" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com