Healthcare Provider Details

I. General information

NPI: 1790305357
Provider Name (Legal Business Name): LEAH JEAN GONZALEZ COHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BERDAN AVE FL 1
WAYNE NJ
07470-3236
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-6457
US

V. Phone/Fax

Practice location:
  • Phone: 973-317-0155
  • Fax: 973-317-0149
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number25MA13206500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number335175
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: