Provider Demographics
NPI:1063711729
Name:SILLIMAN COHEN, RACHEL ISABEL (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ISABEL
Last Name:SILLIMAN COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ISABEL
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:42 E LAUREL RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1354
Mailing Address - Country:US
Mailing Address - Phone:856-566-7036
Mailing Address - Fax:856-566-6108
Practice Address - Street 1:42 E LAUREL RD STE 1100
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-566-7036
Practice Address - Fax:856-566-6108
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA103121002080C0008X, 208000000X
RILP034022080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0647233Medicaid