Healthcare Provider Details

I. General information

NPI: 1821350398
Provider Name (Legal Business Name): DANIEL JONATHAN COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 08/03/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 FORBES AVE STE 907
PITTSBURGH PA
15213-3314
US

IV. Provider business mailing address

3501 FORBES AVE FL 9
PITTSBURGH PA
15213-3317
US

V. Phone/Fax

Practice location:
  • Phone: 412-246-5281
  • Fax: 412-246-5858
Mailing address:
  • Phone: 412-246-5281
  • Fax: 412-246-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberMD453149
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD453149
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: