Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA11206600 | NJ |
Y | 2080P0201X | Pediatric Allergist | 25MA11206600 | NJ |
NPI | 1619361151 |
---|---|
Provider Name | Barrie Cohen |
First Address | West Orange, NJ 07052-3662 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2015 |
Last Update Date | 10/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25MA11206600 | NJ STATE BOARD (01) |