Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 172150 | NY |
NPI | 1831196526 |
---|---|
Provider Name | Jeffrey M Cohen |
First Address | New York, NY 10016-2708 |
Second Address | New York, NY 10016-2708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E59258 | (02) |