Healthcare Provider Details

I. General information

NPI: 1164405809
Provider Name (Legal Business Name): HAIM COHEN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 SMITH RD STE B
NORWOOD OH
45212-2793
US

IV. Provider business mailing address

PO BOX 637783
CINCINNATI OH
45263-7783
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-4848
  • Fax: 513-872-7825
Mailing address:
  • Phone: 513-853-4749
  • Fax: 513-853-4740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number36003318C
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36003318C
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number36003318C
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: