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NPI Code Detail

MEDICARE: DR. EVAN BRUCE COHEN M.D.

MEDICARE: DR. EVAN BRUCE COHEN M.D.
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
1207RG0100XGastroenterology Physician6867RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1406204OTHERRITUFTS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31143OTHERRINEIGHBORHOOD HEALTH PLAN OF RI
4303204OTHERRIHARVARD PILGRIM

General Provider Information

NPI Number : 1538158068
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVAN BRUCE COHEN M.D.
Provider Business Mailing Address
First Line : 44 W RIVER ST
Second Line :
City : PROVIDENCE
State : RI
Zip : 02904-2609
Country : US
Telephone Number : 401-274-4800
Fax Number : 401-454-0410
Provider Business Practice Location Address
First Line : 44 W RIVER ST
Second Line :
City : PROVIDENCE
State : RI
Zip : 02904-2609
Country : US
Telephone Number : 401-274-4800
Fax Number : 401-454-0410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 01/08/2009

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