Provider Demographics
NPI:1316343213
Name:COHEN NIMMO CENTER, P.C.
Entity type:Organization
Organization Name:COHEN NIMMO CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-681-4747
Mailing Address - Street 1:4627 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3661
Mailing Address - Country:US
Mailing Address - Phone:412-681-4747
Mailing Address - Fax:412-681-1684
Practice Address - Street 1:4627 5TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3661
Practice Address - Country:US
Practice Address - Phone:412-681-4747
Practice Address - Fax:412-681-1684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007812-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019115450001Medicaid
PA039348FW4Medicare PIN
PAU81061Medicare UPIN