Healthcare Provider Details

I. General information

NPI: 1427664572
Provider Name (Legal Business Name): LEIGH ANN COHEN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LINCOLN AVE STE 301
ROCKVILLE CENTRE NY
11570-5775
US

IV. Provider business mailing address

3486 WOODWARD ST
OCEANSIDE NY
11572-4531
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-2000
  • Fax:
Mailing address:
  • Phone: 516-779-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF383140-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: