Provider Demographics
NPI:1215196753
Name:ROBERT S COHEN MD PA
Entity type:Organization
Organization Name:ROBERT S COHEN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:201-996-9449
Mailing Address - Street 1:140 PROSPECT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2255
Mailing Address - Country:US
Mailing Address - Phone:201-996-9449
Mailing Address - Fax:201-342-0165
Practice Address - Street 1:140 PROSPECT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2255
Practice Address - Country:US
Practice Address - Phone:201-996-9449
Practice Address - Fax:201-342-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02382900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD97023Medicare UPIN
NJ039734Medicare PIN