Provider Demographics
NPI:1356811996
Name:COCHRANE, JAMES KEVIN (LMT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KEVIN
Last Name:COCHRANE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BRANDYWYNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2853
Mailing Address - Country:US
Mailing Address - Phone:845-633-2312
Mailing Address - Fax:
Practice Address - Street 1:53 BRANDYWYNE DRIVE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2853
Practice Address - Country:US
Practice Address - Phone:845-633-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005044-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist