Healthcare Provider Details
I. General information
NPI: 1558304873
Provider Name (Legal Business Name): BARBARA ELISABETH COHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/14/2006
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
42 E LAUREL RD UDP #1100
STRATFORD NJ
08084-1354
US
IV. Provider business mailing address
42 E LAUREL RD UDP #1100
STRATFORD NJ
08084-1354
US
V. Phone/Fax
- Phone: 856-566-7036
- Fax: 856-566-6108
- Phone: 856-566-7036
- Fax: 856-566-6108
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD030719E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 25MA02888100 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: