Provider Demographics
NPI:1154396034
Name:COHEN, YARIV (MD)
Entity type:Individual
Prefix:DR
First Name:YARIV
Middle Name:
Last Name:COHEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 PIPER STREET STE A.
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-222-4624
Mailing Address - Fax:907-222-4651
Practice Address - Street 1:3650 PIPER STREET STE A.
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-222-4624
Practice Address - Fax:907-222-4651
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361008292085R0202X
CODR.00742122085R0202X
AKMEDS79172086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CN0576OtherGR NUMBER
P00078265OtherRRMC
ILF100093070OtherMEDICARE PTAN
CO9000237995Medicaid
IL036104855Medicaid
IL1615419OtherBCBS
IL036104855Medicaid