Provider Demographics
NPI:1346893336
Name:COHEN, GREGORY MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MICHAEL
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:720 HARRISON AVE BOSTON MEDICAL CENTER, DOCTORS OFFICE
Mailing Address - Street 2:SUITE 7600
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:857-707-9150
Mailing Address - Fax:617-638-8724
Practice Address - Street 1:720 HARRISON AVE BOSTON MEDICAL CENTER, DOCTORS OFFICE
Practice Address - Street 2:SUITE 7600
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8670
Practice Address - Fax:617-638-8724
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MA2817342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program