MEDICARE: SANDRA J. GOLDMAN-COHEN, O.D., LLC

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	152WP0200X	Pediatric Optometrist	TUV4127-1	NY

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	:	1700117710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA J. GOLDMAN-COHEN, O.D., LLC

Provider Business Mailing Address
First Line	:	2385 ARTHUR AVE
Second Line	:	SUITE 203
City	:	BRONX
State	:	NY
Zip	:	10458-8184
Country	:	US
Telephone Number	:	718-562-2481
Fax Number	:	718-562-2482

Provider Business Practice Location Address
First Line	:	2385 ARTHUR AVE
Second Line	:	SUITE 203
City	:	BRONX
State	:	NY
Zip	:	10458-8184
Country	:	US
Telephone Number	:	718-562-2481
Fax Number	:	718-562-2482

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. SANDRA J. GOLDMAN-COHEN
Credential	:	O.D.
Telephone Number	:	201-406-1193

Provider Enumeration Date	:	01/15/2010
Last Update Date	:	01/15/2010

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