Provider Demographics
NPI:1427108414
Name:COHEN, ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:COHEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-398-6256
Mailing Address - Fax:
Practice Address - Street 1:707 IOWA AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:IA
Practice Address - Zip Code:51529-1335
Practice Address - Country:US
Practice Address - Phone:712-643-2298
Practice Address - Fax:712-643-5630
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine