Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 22DI01453700 | NJ |
NPI | 1073664058 |
---|---|
Provider Name | Dr. Elliot N. Cohen |
First Address | Livingston, NJ 07039-5604 |
Second Address | Livingston, NJ 07039-5604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |