Healthcare Provider Details

I. General information

NPI: 1477545150
Provider Name (Legal Business Name): MARTIN E COHEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 SUMMIT AVE
WESTFIELD NJ
07090-3217
US

IV. Provider business mailing address

434 SUMMIT AVE
WESTFIELD NJ
07090-3217
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-5353
  • Fax: 908-232-3481
Mailing address:
  • Phone: 908-654-5353
  • Fax: 908-232-3481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1670
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: