Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD019399E | PA |
NPI | 1104819150 |
---|---|
Provider Name | Dr. John R Cohn |
First Address | Philadelphia, PA 19107-4316 |
Second Address | Philadelphia, PA 19107-4316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 30/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0008813700002 | (05) | PA |
E55783 | (02) | |
E55783 | (02) | PA |