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General NPI Number Information
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NPI Number | 1134291768
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Entity Type | Individual
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Provider Name | CHARLES MELVIN COHEN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 307 4TH AVE SUITE 503
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City | PITTSBURGH
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State | PA
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Zip | 15222-2108
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Country | US
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Telephone | 412-434-0855
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Fax |
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Provider Business Mailing Address
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Address Line | 2387 W GATE DR
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City | PITTSBURGH
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State | PA
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Zip | 15237-1623
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Country | US
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Telephone | 412-367-8480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS001631L
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License Number State | PA
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