Healthcare Provider Details

I. General information

NPI: 1619949716
Provider Name (Legal Business Name): DAVID M COOPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

100 MADISON AVENUE
MORRISTOWN NJ
07962-0001
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-7185
  • Fax:
Mailing address:
  • Phone: 973-971-7755
  • Fax: 973-290-7360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number25MA06507900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: