Provider Demographics
NPI:1275616609
Name:COHEN, RAYMOND F (DO)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:F
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 BELL AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-3663
Mailing Address - Country:US
Mailing Address - Phone:636-778-3312
Mailing Address - Fax:636-532-6194
Practice Address - Street 1:1505 S BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-2205
Practice Address - Country:US
Practice Address - Phone:314-384-1006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO362722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AC2061909OtherDEA
B18430Medicare UPIN