Provider Demographics
NPI:1396757944
Name:ROBERT J COHEN DPM PC
Entity type:Organization
Organization Name:ROBERT J COHEN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-354-7222
Mailing Address - Street 1:72 COVERT AVE
Mailing Address - Street 2:
Mailing Address - City:STEWART MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-354-7222
Mailing Address - Fax:516-354-7200
Practice Address - Street 1:72 COVERT AVE
Practice Address - Street 2:
Practice Address - City:STEWART MANOR
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-354-7222
Practice Address - Fax:516-354-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002644213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00422775Medicaid
NY00422775Medicaid
NYP30252Medicare PIN