Provider Demographics
NPI:1316768799
Name:ADAM BENJAMIN COHEN MD NJ LLC
Entity type:Organization
Organization Name:ADAM BENJAMIN COHEN MD NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-688-3710
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:GREAT RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11739-0626
Mailing Address - Country:US
Mailing Address - Phone:631-892-2745
Mailing Address - Fax:631-201-3179
Practice Address - Street 1:34 S DEAN ST # 202
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3515
Practice Address - Country:US
Practice Address - Phone:212-688-3710
Practice Address - Fax:212-688-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty