Healthcare Provider Details
I. General information
NPI: 1982474342
Provider Name (Legal Business Name): KRISTEN LEANNE COHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/08/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1820 CORLIES AVE STE 7
NEPTUNE NJ
07753-4989
US
IV. Provider business mailing address
39 ANNAPOLIS DR
HAZLET NJ
07730-2301
US
V. Phone/Fax
- Phone: 732-927-5541
- Fax:
- Phone: 732-768-6944
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 26NJ14867300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: