MEDICARE: COHEN DERMATOPATHOLOGY, P.C.

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	207ND0900X	Dermatopathology Physician	2663	MA
2	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1477522910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COHEN DERMATOPATHOLOGY, P.C.

Provider Business Mailing Address
First Line	:	1111 S FREEPORT PKWY
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4435
Country	:	US
Telephone Number	:	866-588-3280
Fax Number	:	972-767-0225

Provider Business Practice Location Address
First Line	:	15 CRAWFORD STREET
Second Line	:	SUITE 100
City	:	NEEDHAM
State	:	MA
Zip	:	02494
Country	:	US
Telephone Number	:	617-969-4100
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JIAN XIE
Credential	:
Telephone Number	:	626-695-2199

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	12/15/2025

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