Provider Demographics
NPI:1104806603
Name:COHEN, JAY STEVEN (MD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:STEVEN
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 452345
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33345-2345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 SW 84TH AVE
Practice Address - Street 2:#D
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2736
Practice Address - Country:US
Practice Address - Phone:954-452-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50970207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09986OtherBCBS
FL09986OtherBCBS
FL09986SMedicare PIN
FL09986OtherBCBS
FL09986TMedicare PIN
FL09986VMedicare PIN
FL09986WMedicare PIN