Provider Demographics
NPI:1770536864
Name:COOKE, HENRY JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:JOHN
Last Name:COOKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 PARK AVE
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5300
Mailing Address - Country:US
Mailing Address - Phone:908-755-0590
Mailing Address - Fax:908-755-0600
Practice Address - Street 1:380 N MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5716
Practice Address - Country:US
Practice Address - Phone:201-880-7077
Practice Address - Fax:201-880-7078
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00362800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
7367058OtherCIGNA
P2521986OtherOXFORD
7367058OtherCIGNA
U31793Medicare UPIN