Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 32367 | NY |
NPI | 1104003672 |
---|---|
Provider Name | Dr. Gary Steven Cohen |
First Address | Lynbrook, NY 11563 |
Second Address | Lynbrook, NY 11563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2008 |
Last Update Date | 28/01/2008 |