Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PA | |
Y | 103T00000X | Psychologist | PA |
NPI | 1013415207 |
---|---|
Provider Name | Mr. Eric R Cohen |
First Address | Elkins Park, PA 19027-1431 |
Second Address | Elkins Park, PA 19027-1431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2018 |
Last Update Date | 23/01/2018 |