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General NPI Number Information
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NPI Number | 1710115746
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Entity Type | Individual
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Provider Name | VIRGINIA S COWEN PHD, MT
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Gender | Female
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 145 PIERMONT ROAD JUMPING FROG STUDIOS
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City | TENAFLY
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State | NJ
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Zip | 07670
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Country | US
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Telephone | 201-414-8093
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Fax |
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Provider Business Mailing Address
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Address Line | 2 BOWERS LN
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City | CLOSTER
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State | NJ
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Zip | 07624-1505
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Country | US
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Telephone | 210-414-8093
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 010575
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License Number State | NY
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