Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 014273 | NY |
N | 2251S0007X | Physical Therapist - Sports | 014273 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 014273 | NY |
NPI | 1235383530 |
---|---|
Provider Name | Michael B Cohen |
First Address | Long Beach, NY 11561-4005 |
Second Address | Long Beach, NY 11561-4005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2008 |
Last Update Date | 13/11/2008 |