Provider Demographics
NPI:1427291970
Name:COHEN, MATTHEW A (MED, CERT FCE)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:COHEN
Suffix:
Gender:M
Credentials:MED, CERT FCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4576
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-4576
Mailing Address - Country:US
Mailing Address - Phone:336-629-6397
Mailing Address - Fax:336-629-6939
Practice Address - Street 1:600 W SALISBURY ST
Practice Address - Street 2:STE. A
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5590
Practice Address - Country:US
Practice Address - Phone:336-629-6397
Practice Address - Fax:336-629-6939
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner