Healthcare Provider Details

I. General information

NPI: 1457324295
Provider Name (Legal Business Name): ALWYN COHALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COLOUMBIA UNIVERSITY DEPARTMENT PEDIATRICS 3959 BROADWAY
NEW YORK NY
10032
US

IV. Provider business mailing address

2600 NETHERLAND AVE APT 2901
BRONX NY
10463-0690
US

V. Phone/Fax

Practice location:
  • Phone: 212-927-3214
  • Fax: 212-544-1974
Mailing address:
  • Phone: 646-685-9639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number153930
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number153930
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: