Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 207896 | NY |
NPI | 1467435081 |
---|---|
Provider Name | Dr. Michael Sam Cohen |
First Address | Syosset, NC 11791 |
Second Address | Syosset, NC 11791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H15089 | (02) | NY |