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NPI 1760420517

NPI 1760420517 : DONNA J COTZEN M.D. : PHILA, PA

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General NPI Number Information
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    NPI Number           |    1760420517
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    Entity Type          |    Individual 
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    Provider Name        |    DONNA J COTZEN M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/03/2006
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    Last Update Date     |    01/30/2012
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Provider Practice Location Address
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    Address Line         |    325 CHESTNUT ST SUITE 905
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    City                 |    PHILA
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    State                |    PA
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    Zip                  |    19106-2614
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    Country              |    US
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    Telephone            |    215-238-1262
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    Fax                  |    215-238-1260
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Provider Business Mailing Address
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    Address Line         |    210 LOCUST ST APT 4A
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    City                 |    PHILA
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    State                |    PA
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    Zip                  |    19106-3934
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    Country              |    US
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    Telephone            |    215-592-9874
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    Fax                  |    215-238-1260
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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        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    MD017885E
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    License Number State |    PA
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