Healthcare Provider Details

I. General information

NPI: 1598950750
Provider Name (Legal Business Name): GREG E COHEN DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 JORALEMON ST STE 1
BROOKLYN NY
11201-4709
US

IV. Provider business mailing address

142 JORALEMON ST STE 1
BROOKLYN NY
11201-4709
US

V. Phone/Fax

Practice location:
  • Phone: 718-624-3003
  • Fax: 718-624-7517
Mailing address:
  • Phone: 718-624-3003
  • Fax: 718-624-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005886
License Number StateNY

VIII. Authorized Official

Name: DR. GREG COHEN
Title or Position: OWNER
Credential: DPM
Phone: 718-624-3003