Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 25MA05848200 | NJ |
NPI | 1013099175 |
---|---|
Provider Name | Shaul Cohen |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901-1928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 15/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6296602 | (05) | NJ |
A64172 | (02) | NJ |