Provider Demographics
NPI:1962447946
Name:COOPER, ALLAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:COOPER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1984
Mailing Address - Country:US
Mailing Address - Phone:609-409-3860
Mailing Address - Fax:609-409-3861
Practice Address - Street 1:60 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3252
Practice Address - Country:US
Practice Address - Phone:609-947-4403
Practice Address - Fax:609-409-3861
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100084700103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ099147Medicare ID - Type UnspecifiedPSYCHOLOGY