Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | NOO3717 | NY |
NPI | 1164492948 |
---|---|
Provider Name | Dr. Melissa J Cohen |
First Address | Cicero, NY 13039-8600 |
Second Address | Cicero, NY 13039-8600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 17/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00852433 | (05) | NY |
T26699 | (02) | NY |