Healthcare Provider Details

I. General information

NPI: 1689727786
Provider Name (Legal Business Name): LOUIS DAVID COHEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 E TREMONT AVE
BRONX NY
10460-4301
US

IV. Provider business mailing address

174 GRAND ST
WHITE PLAINS NY
10601-4803
US

V. Phone/Fax

Practice location:
  • Phone: 914-328-8077
  • Fax: 914-328-6079
Mailing address:
  • Phone: 914-328-8077
  • Fax: 914-328-6079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX02939
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: