Healthcare Provider Details

I. General information

NPI: 1700117710
Provider Name (Legal Business Name): SANDRA J. GOLDMAN-COHEN, O.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 ARTHUR AVE SUITE 203
BRONX NY
10458-8184
US

IV. Provider business mailing address

2385 ARTHUR AVE SUITE 203
BRONX NY
10458-8184
US

V. Phone/Fax

Practice location:
  • Phone: 718-562-2481
  • Fax: 718-562-2482
Mailing address:
  • Phone: 718-562-2481
  • Fax: 718-562-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberTUV4127-1
License Number StateNY

VIII. Authorized Official

Name: DR. SANDRA J. GOLDMAN-COHEN
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 201-406-1193