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General NPI Number Information
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NPI Number | 1881930683
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Entity Type | Individual
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Provider Name | DR. YITZCHAK COHEN
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Gender | Male
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Dates
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Enumeration Date | 12/26/2012
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 105 UNION ST APT 1AB
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City | LODI
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State | NJ
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Zip | 07644-3226
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Country | US
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Telephone | 201-654-6507
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1054
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City | CLIFTON
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State | NJ
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Zip | 07014-1054
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Country | US
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Telephone | 201-654-6507
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | R84297
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License Number State | NY
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