Healthcare Provider Details

I. General information

NPI: 1033184601
Provider Name (Legal Business Name): DR. DANIEL COHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 05/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 WESTCHESTER AVE
PURCHASE NY
10577-2574
US

IV. Provider business mailing address

99 FIELDSTONE DR
HARTSDALE NY
10530-1564
US

V. Phone/Fax

Practice location:
  • Phone: 914-607-6260
  • Fax: 914-607-6261
Mailing address:
  • Phone: 914-428-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2099941
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: