Provider Demographics
NPI:1861599136
Name:THOMAS R COOKSON INC
Entity type:Organization
Organization Name:THOMAS R COOKSON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:COOKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:978-535-1213
Mailing Address - Street 1:100 CORPORATE PL
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3865
Mailing Address - Country:US
Mailing Address - Phone:978-535-1213
Mailing Address - Fax:978-535-5510
Practice Address - Street 1:100 CORPORATE PL
Practice Address - Street 2:SUITE 103
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3865
Practice Address - Country:US
Practice Address - Phone:978-535-1213
Practice Address - Fax:978-535-5510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA66728OtherCIGNA
MA699453OtherTUFTS
MA0024872OtherNEIGHBORHOOD HEALTH
MA2977522OtherAETNA
MAY61296OtherBLUE CROSS
MA626323OtherHARVARD PILGRIM
MA9720740Medicaid
MA66728OtherCIGNA