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General NPI Number Information
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NPI Number | 1720453962
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Entity Type | Organization
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Legal Business Name | ELIZABETH COHEN PHD
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Dates
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Enumeration Date | 12/13/2015
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Last Update Date | 12/13/2015
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Provider Practice Location Address
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Address Line | 164 W 80TH ST BASEMENT SUITE OFFICE #3
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City | NEW YORK
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State | NY
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Zip | 10024-6357
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Country | US
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Telephone | 917-596-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 164 W 80TH ST BASEMENT SUITE OFFICE #3
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City | NEW YORK
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State | NY
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Zip | 10024-6357
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Country | US
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Telephone | 917-596-8955
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ELIZABETH COHEN
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Credential |
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Telephone | 917-596-8955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 201318468
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License Number State | NY
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