Provider Demographics
NPI:1104819150
Name:COHN, JOHN R (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:COHN
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 1:1015 CHESTNUT ST
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4316
Mailing Address - Country:US
Mailing Address - Phone:215-923-7685
Mailing Address - Fax:215-923-8230
Practice Address - Street 1:1015 CHESTNUT ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4316
Practice Address - Country:US
Practice Address - Phone:215-923-7685
Practice Address - Fax:215-923-8230
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019399E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008813700002Medicaid
E55783Medicare UPIN
PAE55783Medicare UPIN
PA115084Medicare PIN