Provider Demographics
NPI:1528092350
Name:COHEN, STEPHEN A (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3606
Mailing Address - Country:US
Mailing Address - Phone:781-652-8484
Mailing Address - Fax:781-240-7700
Practice Address - Street 1:4 OAKLAND ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3606
Practice Address - Country:US
Practice Address - Phone:781-652-8484
Practice Address - Fax:781-240-7700
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203617207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology