Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 7542 | NY |
NPI | 1023316833 |
---|---|
Provider Name | Dr. Michael Cohen |
First Address | Long Beach, NY 11561-4101 |
Second Address | Long Beach, NY 11561-4101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2011 |
Last Update Date | 14/10/2011 |