Provider Demographics
NPI:1992782346
Name:COHEN, LAUREN J (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:J
Last Name:COHEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 N ROSE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1153
Mailing Address - Country:US
Mailing Address - Phone:410-685-6028
Mailing Address - Fax:
Practice Address - Street 1:220 W COLD SPRING LANE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210
Practice Address - Country:US
Practice Address - Phone:443-524-6600
Practice Address - Fax:443-524-6608
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLX90LI64720901OtherBLUE SHIELD
MDP00189239Medicare ID - Type UnspecifiedRR
MDLX90LI64720901OtherBLUE SHIELD