MEDICARE: HARALD J COHEN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	38816	NY

General Provider Information

NPI Number	:	1215110184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARALD J COHEN RPH

Provider Business Mailing Address
First Line	:	215 PARK LN
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2141
Country	:	US
Telephone Number	:	315-458-6434
Fax Number	:

Provider Business Practice Location Address
First Line	:	3035 EAST AVE
Second Line	:
City	:	CENTRAL SQUARE
State	:	NY
Zip	:	13036-2611
Country	:	US
Telephone Number	:	315-668-7363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	12/13/2007

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