Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MEDS7917 | AK |
NPI | 1154396034 |
---|---|
Provider Name | Dr. Yariv Cohen |
First Address | Anchorage, AK 99508 |
Second Address | Anchorage, AK 99508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 11/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036104855 | (05) | IL |
1615419 | BCBS (01) | IL |
CN0576 | GR NUMBER (01) | |
F100093070 | MEDICARE PTAN (01) | IL |
H28295 | (02) | |
P00078265 | RRMC (01) |