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General NPI Number Information
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NPI Number | 1366427007
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Entity Type | Individual
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Provider Name | DOUGLAS J COHEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 204 ARK RD STE 206 LMC I
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-3100
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Country | US
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Telephone | 856-778-4640
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Fax | 856-778-8862
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Provider Business Mailing Address
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Address Line | 204 ARK RD STE 206 LMC I
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-3100
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Country | US
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Telephone | 856-778-4640
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Fax | 856-778-8862
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA03715200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25MA03715200
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License Number State | NJ
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