Provider Demographics
NPI:1063590537
Name:COHEN, JASON BRETT (DPM)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRETT
Last Name:COHEN
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4305
Mailing Address - Country:US
Mailing Address - Phone:718-617-3668
Mailing Address - Fax:718-617-3824
Practice Address - Street 1:949 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4305
Practice Address - Country:US
Practice Address - Phone:718-617-3668
Practice Address - Fax:718-617-3824
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005736213E00000X, 213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02396445Medicaid
NYU95566Medicare UPIN
NYPH6521Medicare PIN