MEDICARE: ERIC COHEN

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	660	MD

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	:	1841593902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC COHEN

Provider Business Mailing Address
First Line	:	6660 SECURITY BLVD # D
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-4012
Country	:	US
Telephone Number	:	410-944-8020
Fax Number	:	410-944-5621

Provider Business Practice Location Address
First Line	:	6660 SECURITY BLVD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-4012
Country	:	US
Telephone Number	:	410-944-8020
Fax Number	:	410-944-5621

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. GERRY N SCHERR
Credential	:	OFFICE MANAGER
Telephone Number	:	410-944-8020

Provider Enumeration Date	:	12/13/2010
Last Update Date	:	08/27/2012

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Directions to “ERIC COHEN ” Practice Location

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