Provider Demographics
NPI:1306909247
Name:COHEN, JAY H (DC)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:H
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 SOLOMONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-1211
Mailing Address - Country:US
Mailing Address - Phone:410-224-3387
Mailing Address - Fax:410-224-3955
Practice Address - Street 1:2770 SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1211
Practice Address - Country:US
Practice Address - Phone:410-224-3387
Practice Address - Fax:410-224-3955
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD41209601OtherBCBS
MD6636OtherUHC
MDT3590002OtherFEDERAL BCBS
MD611636OtherMDIPA
MDT3590002OtherFEDERAL BCBS
MD611636OtherMDIPA