Healthcare Provider Details

I. General information

NPI: 1841302908
Provider Name (Legal Business Name): JASON ARI COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 WESTCHESTER AVE STE 331
WHITE PLAINS NY
10604-3516
US

IV. Provider business mailing address

1133 WESTCHESTER AVE STE 331
WHITE PLAINS NY
10604-3516
US

V. Phone/Fax

Practice location:
  • Phone: 914-934-5810
  • Fax:
Mailing address:
  • Phone: 914-934-5810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number228809-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number228809-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: