Healthcare Provider Details

I. General information

NPI: 1326950056
Provider Name (Legal Business Name): BROOKE CARA COHEN RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 CAMBRIDGE ST
BOSTON MA
02129-1309
US

IV. Provider business mailing address

34 CAMBRIDGE ST APT 2325
CHARLESTOWN MA
02129-1329
US

V. Phone/Fax

Practice location:
  • Phone: 973-908-5131
  • Fax:
Mailing address:
  • Phone: 973-908-5131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: