Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 70188 | OH |
NPI | 1114906831 |
---|---|
Provider Name | Dr. Jennifer Van Noy Cochran |
First Address | South Euclid, OH 44121-4128 |
Second Address | South Euclid, OH 44121-4128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 19/11/2020 |