Healthcare Provider Details

I. General information

NPI: 1487813663
Provider Name (Legal Business Name): COHEN ROSEN KAUFMAN AND CHEN DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 ENGLE STREET
ENGLEWOOD NJ
07631-2507
US

IV. Provider business mailing address

142 ENGLE ST
ENGLEWOOD NJ
07631-2504
US

V. Phone/Fax

Practice location:
  • Phone: 201-235-0033
  • Fax:
Mailing address:
  • Phone: 201-568-0033
  • Fax: 201-568-9891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMD001006
License Number StateNJ

VIII. Authorized Official

Name: RICHARD C ROSEN
Title or Position: OWNER
Credential: DPM
Phone: 201-568-0033