Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N2839 | NY |
NPI | 1336286731 |
---|---|
Provider Name | Dr. Lawrence Marc Cohen |
First Address | Valley Stream, NY 11581-1329 |
Second Address | Valley Stream, NY 11581-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 14/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00403838 | (05) | NY |
T50892 | (02) | NY |