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General NPI Number Information
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NPI Number | 1316768799
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Entity Type | Organization
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Legal Business Name | ADAM BENJAMIN COHEN MD NJ LLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 34 S DEAN ST # 202
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-3515
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Country | US
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Telephone | 212-688-3710
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Fax | 212-688-3712
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Provider Business Mailing Address
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Address Line | PO BOX 626
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City | GREAT RIVER
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State | NY
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Zip | 11739-0626
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Country | US
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Telephone | 631-892-2745
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Fax | 631-201-3179
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Authorized Official
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Title or Position | OWNER
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Name | ADAM BENJAMIN COHEN
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Credential | MD
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Telephone | 212-688-3710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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