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NPI 1720164114

NPI 1720164114 : LOUISE COHEN CSW : IRVINGTON, NJ

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General NPI Number Information
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    NPI Number           |    1720164114
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    Entity Type          |    Individual 
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    Provider Name        |    LOUISE COHEN CSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/27/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    21-29 WAGNER PLACE 
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    City                 |    IRVINGTON
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    State                |    NJ
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    Zip                  |    07111
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    Country              |    US
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    Telephone            |    973-399-3132
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    Fax                  |    973-399-7552
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Provider Business Mailing Address
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    Address Line         |    21-29 WAGNER PLACE 
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    City                 |    IRVINGTON
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    State                |    NJ
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    Zip                  |    07111
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    Country              |    US
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    Telephone            |    973-399-3132
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    Fax                  |    973-399-7552
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    44SW00339800
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    License Number State |    NJ
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