Provider Demographics
NPI:1487282398
Name:COHN, ELIZABETH (NP; PHD)
Entity type:Individual
Prefix:PROF
First Name:ELIZABETH
Middle Name:
Last Name:COHN
Suffix:
Gender:F
Credentials:NP; PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 GLENLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SEA CLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:11579-1716
Mailing Address - Country:US
Mailing Address - Phone:516-721-8555
Mailing Address - Fax:
Practice Address - Street 1:72 GLENLAWN AVE
Practice Address - Street 2:
Practice Address - City:SEA CLIFF
Practice Address - State:NY
Practice Address - Zip Code:11579-1716
Practice Address - Country:US
Practice Address - Phone:516-721-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302479-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health