Provider Demographics
NPI:1316068786
Name:COHEN, JONA (NP)
Entity type:Individual
Prefix:MRS
First Name:JONA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROSS RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2606
Mailing Address - Country:US
Mailing Address - Phone:781-595-9554
Mailing Address - Fax:
Practice Address - Street 1:405 GREAT PLAIN AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-3735
Practice Address - Country:US
Practice Address - Phone:781-453-2962
Practice Address - Fax:781-453-2966
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105808363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1664Medicare ID - Type UnspecifiedMADICARE PART B