Provider Demographics
NPI:1396887873
Name:COHEN, LISA JANET (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:JANET
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1ST AVE. & 16TH ST.
Mailing Address - Street 2:6 KARPAS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-420-2316
Mailing Address - Fax:212-844-7659
Practice Address - Street 1:1ST AVE. & 16TH ST.
Practice Address - Street 2:6 KARPAS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2316
Practice Address - Fax:212-844-7659
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011743103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP543392OtherOXFORD
NYP543392OtherOXFORD