Provider Demographics
NPI:1225388754
Name:HOWARD B. KOOK, D.C., P.C.
Entity Type:Organization
Organization Name:HOWARD B. KOOK, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-762-2526
Mailing Address - Street 1:1955 SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3441
Mailing Address - Country:US
Mailing Address - Phone:973-762-2526
Mailing Address - Fax:973-762-1713
Practice Address - Street 1:1955 SPRINGFIELD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3441
Practice Address - Country:US
Practice Address - Phone:973-762-2526
Practice Address - Fax:973-762-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
NJ38MC0288000261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8764603Medicaid