Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 78420 | MA |
NPI | 1174624480 |
---|---|
Provider Name | Gabriel M Cohn |
First Address | Springfield, MA 01199-1000 |
Second Address | Springfield, MA 01199-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F20028 | (02) | MA |