Healthcare Provider Details

I. General information

NPI: 1861465387
Provider Name (Legal Business Name): ERIK LOUIS COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 OLD POST RD NO 2
GREENWICH CT
06830-6786
US

IV. Provider business mailing address

57 OLD POST ROAD NO. 2
GREENWICH CT
06830
US

V. Phone/Fax

Practice location:
  • Phone: 203-661-6430
  • Fax: 203-661-2597
Mailing address:
  • Phone: 203-661-6430
  • Fax: 203-661-2597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number040445
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: