Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | MD047030 | DC |
NPI | 1790929701 |
---|---|
Provider Name | Dr. Justin Craig Cohen |
First Address | Washington, DC 20037-1449 |
Second Address | Washington, DC 20037-1449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 05/09/2019 |