Healthcare Provider Details

I. General information

NPI: 1972508554
Provider Name (Legal Business Name): DR. THOMAS P. COCKE
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 OLD HOOK RD STE 200
WESTWOOD NJ
07675-3200
US

IV. Provider business mailing address

333 OLD HOOK RD STE 200
WESTWOOD NJ
07675-3200
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-0201
  • Fax: 201-666-7970
Mailing address:
  • Phone: 201-664-0201
  • Fax: 201-666-7970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA06003900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: