Healthcare Provider Details

I. General information

NPI: 1801952668
Provider Name (Legal Business Name): KENNETH HOWARD COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 LADD ST FL 4
PORTSMOUTH NH
03801-4087
US

IV. Provider business mailing address

116 AMESBURY RD
KENSINGTON NH
03833-5621
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-8228
  • Fax: 603-433-6341
Mailing address:
  • Phone: 603-772-2909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6229
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: