Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 000262 | NY |
NPI | 1245640267 |
---|---|
Provider Name | Mr. Jeffrey Theodore Cohen |
First Address | New York, NY 10012 |
Second Address | New York, NY 10012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 09/05/2014 |