Healthcare Provider Details

I. General information

NPI: 1881754380
Provider Name (Legal Business Name): OFER A COHEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 WEST 231ST 2ND FLOOR
BRONX NY
10463
US

IV. Provider business mailing address

183 WEST 231ST 2ND FLOOR
BRONX NY
10463
US

V. Phone/Fax

Practice location:
  • Phone: 718-543-1123
  • Fax: 718-581-2681
Mailing address:
  • Phone: 718-543-1123
  • Fax: 718-581-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number049585
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: