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General NPI Number Information
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NPI Number | 1902560964
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Entity Type | Organization
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Legal Business Name | DIABETES & ENDOCRINE PLLC
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 632 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2728
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Country | US
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Telephone | 631-939-2127
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Fax | 718-892-0736
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Provider Business Mailing Address
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Address Line | 632 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2728
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Country | US
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Telephone | 631-939-2127
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Fax | 718-892-0736
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARMIAN COHEN
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Credential | MD
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Telephone | 631-939-2127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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