MEDICARE: DR. ALLEN H COHEN O.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
1	152W00000X	Optometrist	2714	NY
2	152W00000X	Optometrist	OD0000002353	TN
3	152WV0400X	Vision Therapy Optometrist	2714	NY

General Provider Information

NPI Number	:	1578568333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN H COHEN O.D.

Provider Business Mailing Address
First Line	:	120 CABRINI BLVD
Second Line	:	APT 59
City	:	NEW YORK
State	:	NY
Zip	:	10033-3438
Country	:	US
Telephone Number	:	646-410-0982
Fax Number	:	646-410-0982

Provider Business Practice Location Address
First Line	:	120 CABRINI BLVD
Second Line	:	APT 59
City	:	NEW YORK
State	:	NY
Zip	:	10033-3438
Country	:	US
Telephone Number	:	646-410-0982
Fax Number	:	646-410-0982

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/03/2010

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