Provider Demographics
NPI:1194770149
Name:COHEN, HOWARD I (OD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:I
Last Name:COHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010
Mailing Address - Country:US
Mailing Address - Phone:516-354-2542
Mailing Address - Fax:516-354-2017
Practice Address - Street 1:828 HEMPSTEAD TURNPIKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010
Practice Address - Country:US
Practice Address - Phone:516-354-2542
Practice Address - Fax:516-354-2017
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0038551152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009715955Medicaid
NY0155740001Medicare NSC
NY009715955Medicaid
T49015Medicare UPIN