Healthcare Provider Details

I. General information

NPI: 1811983034
Provider Name (Legal Business Name): TODD COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTHERN BLVD AT VALENTINES LANE RILAND HEALTHCARE CENTER - NYIT
OLD WESTBURY NY
11568
US

IV. Provider business mailing address

120 MINEOLA BLVD SUITE 500
MINEOLA NY
11501-4073
US

V. Phone/Fax

Practice location:
  • Phone: 516-287-8898
  • Fax: 516-730-9569
Mailing address:
  • Phone: 516-663-8530
  • Fax: 516-663-8546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number165465
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: