Provider Demographics
NPI:1194259333
Name:HAIZLER-COHEN, LYLACH (MD)
Entity type:Individual
Prefix:MRS
First Name:LYLACH
Middle Name:
Last Name:HAIZLER-COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 KAPLANSKI ST
Mailing Address - Street 2:
Mailing Address - City:YAHUD
Mailing Address - State:CENTRAL ISRAEL
Mailing Address - Zip Code:5620106
Mailing Address - Country:IL
Mailing Address - Phone:97254-811-7828
Mailing Address - Fax:9723-632-3287
Practice Address - Street 1:475 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3436
Practice Address - Country:US
Practice Address - Phone:718-226-8074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program