MEDICARE: MR. DANIEL M COHEN PHD

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	103T00000X	Psychologist	013987	NY
2	103T00000X	Psychologist	2900	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609870492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL M COHEN PHD

Provider Business Mailing Address
First Line	:	512 KAPPOCK ST
Second Line	:	2H
City	:	BRONX
State	:	NY
Zip	:	10463-6404
Country	:	US
Telephone Number	:	917-796-0498
Fax Number	:

Provider Business Practice Location Address
First Line	:	512 KAPPOCK ST
Second Line	:	2H
City	:	BRONX
State	:	NY
Zip	:	10463-6404
Country	:	US
Telephone Number	:	917-796-0498
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	06/03/2013

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