Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS018249L | PA |
NPI | 1073650198 |
---|---|
Provider Name | Dr. Harold J Cohen |
First Address | Hanover, PA 17331-1813 |
Second Address | Hanover, PA 17331-1813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
57170 | UNITED CONCORDIA ID (01) | PA |