Provider Demographics
NPI:1699713909
Name:COHEN, ROBERT I (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:I
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 1:10 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2113
Mailing Address - Country:US
Mailing Address - Phone:617-765-4963
Mailing Address - Fax:617-607-6049
Practice Address - Street 1:10 LAUREL ST
Practice Address - Street 2:
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-2113
Practice Address - Country:US
Practice Address - Phone:508-847-5458
Practice Address - Fax:617-607-6049
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56855207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110044663AMedicaid
MAS400180164Medicare PIN