Provider Demographics
NPI:1962478008
Name:COHEN, JEFFREY P (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-8105
Practice Address - Street 1:61 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-1315
Practice Address - Country:US
Practice Address - Phone:085-248-1745
Practice Address - Fax:508-434-0206
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
J12596OtherBLUE SHIELD INDEMNITY
J12596OtherBLUE CARE ELECT
042472266OtherONE HEALTH PLAN
406057OtherTUFTS HEALTH PLAN
042472266OtherTHREE RIVERS
043058466OtherTRICARE CHAMPUS
26722OtherHEALTHY START
MA3100235Medicaid
0100249OtherEVERCARE
7522604OtherAETNA US HEALTHCARE
917599OtherFIRST HEALTH
042472266OtherUNITED HEALTHCARE
2973114OtherCIGNA HEALTH PLAN
9900891OtherFALLON COMM HEALTH PLAN
J12596OtherBLUE SHIELD HMO BLUE
AA1280OtherHARVARD PILGRIM
26722OtherCHILDRENS MED SECURITY
784236OtherMVP HEALTH CARE
26722OtherHEALTHY START
7522604OtherAETNA US HEALTHCARE