Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 11334 | MA |
NPI | 1033237896 |
---|---|
Provider Name | Dr. Edward Cohen |
First Address | Sharon, MA 02067-2430 |
Second Address | Newton Highlands, MA 02461-1439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 15/01/2008 |