Provider Demographics
NPI:1306625363
Name:COHEN, LINDA S (MA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 EASTERN PKWY APT 1C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3403
Mailing Address - Country:US
Mailing Address - Phone:917-434-3429
Mailing Address - Fax:
Practice Address - Street 1:706 EASTERN PKWY APT 1C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3403
Practice Address - Country:US
Practice Address - Phone:917-434-3429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY$$$-$$-$$$$174400000X
NY577-2-6458174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist