MEDICARE: AUTUMN B COHEN CNMW

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	367A00000X	Advanced Practice Midwife	MW010123	PA

General Provider Information

NPI Number	:	1811955016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMN B COHEN CNMW

Provider Business Mailing Address
First Line	:	1500 MARKET ST
Second Line	:	24TH FLOOR WEST TOWER
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2100
Country	:	US
Telephone Number	:	215-255-3529
Fax Number	:	215-832-2213

Provider Business Practice Location Address
First Line	:	1427 VINE ST
Second Line	:	7TH FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-1031
Country	:	US
Telephone Number	:	215-762-7824
Fax Number	:	215-246-5257

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	03/14/2013

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