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General NPI Number Information
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NPI Number | 1770619629
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Entity Type | Individual
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Provider Name | ROBERT H COHEN P.A.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 975 STEWART AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-4816
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Country | US
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Telephone | 516-222-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 1637 160TH ST
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City | WHITESTONE
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State | NY
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Zip | 11357-3242
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Country | US
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Telephone | 718-352-7646
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 00055581
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License Number State | NY
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