MEDICARE: DR. LARRY WARREN COHEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD026348E	PA

General Provider Information

NPI Number	:	1013992957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY WARREN COHEN M.D.

Provider Business Mailing Address
First Line	:	41 UNIVERSITY DR
Second Line	:
City	:	NEWTOWN
State	:	PA
Zip	:	18940-1873
Country	:	US
Telephone Number	:	215-710-7037
Fax Number	:

Provider Business Practice Location Address
First Line	:	14425 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-1177
Country	:	US
Telephone Number	:	215-464-9599
Fax Number	:	215-464-7865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	05/28/2021

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