Healthcare Provider Details

I. General information

NPI: 1154741510
Provider Name (Legal Business Name): LILA BETH COHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST. SUITE 205
CONCORD NH
03301-2548
US

IV. Provider business mailing address

246 PLEASANT ST. SUITE 205
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-0584
  • Fax: 603-227-7560
Mailing address:
  • Phone: 603-224-0584
  • Fax: 603-227-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20552
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: