=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538370044
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WENDY E COHEN MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2007
-----------------------------------------------------
Last Update Date | 07/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 166 ENGLE ST
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07631-2507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-567-5376
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 588
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-567-5376
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES
-----------------------------------------------------
Name | WENDY COHEN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 201-567-5376
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 32189
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------