Healthcare Provider Details

I. General information

NPI: 1295839660
Provider Name (Legal Business Name): BARRY ALAN COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ALICE PECK DAY DR
LEBANON NH
03766-2900
US

IV. Provider business mailing address

10 ALICE PECK DAY DR
LEBANON NH
03766-2900
US

V. Phone/Fax

Practice location:
  • Phone: 603-448-3121
  • Fax:
Mailing address:
  • Phone: 603-448-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number25MA07789600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number20332
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: