Healthcare Provider Details

I. General information

NPI: 1164760393
Provider Name (Legal Business Name): MICHAEL H COHEN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FT WASHINGTN AVE
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

161 FT WASHINGTN AVE
NEW YORK NY
10032-3729
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5440
  • Fax: 212-305-3542
Mailing address:
  • Phone: 212-305-5440
  • Fax: 212-305-3542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number103006
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number103006
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL H COHEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-305-5440