MEDICARE: PETER SOLIS-COHEN PT, DPT

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	2251X0800X	Orthopedic Physical Therapist	19988	MA
2	225100000X	Physical Therapist	19988	MA

General Provider Information

NPI Number	:	1942568407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER SOLIS-COHEN PT, DPT

Provider Business Mailing Address
First Line	:	344 WOODWARD AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14214-1962
Country	:	US
Telephone Number	:	845-750-2983
Fax Number	:

Provider Business Practice Location Address
First Line	:	3240 S DEXTER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-7226
Country	:	US
Telephone Number	:	845-750-2983
Fax Number	:

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

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	05/06/2019

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