MEDICARE: VICTOR COHEN D.P.M.

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	213E00000X	Podiatrist	SC002973L	PA
2	213ES0131X	Foot Surgery Podiatrist	SC002973L	PA

General Provider Information

NPI Number	:	1760478333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR COHEN D.P.M.

Provider Business Mailing Address
First Line	:	205 GRANDVIEW AVE
Second Line	:	SUITE 208
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-761-6350
Fax Number	:	717-761-6350

Provider Business Practice Location Address
First Line	:	205 GRANDVIEW AVE
Second Line	:	SUITE 208
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-761-6350
Fax Number	:	717-761-6350

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	06/06/2008

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Directions to “ VICTOR COHEN D.P.M.” Practice Location

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