MEDICARE: MARC LEWIS 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1053109025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC LEWIS COHEN M.D.

Provider Business Mailing Address
First Line	:	4777 E. GALBRAITH ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236
Country	:	US
Telephone Number	:	513-686-5446
Fax Number	:	513-686-6868

Provider Business Practice Location Address
First Line	:	4777 E. GALBRAITH ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236
Country	:	US
Telephone Number	:	513-686-5446
Fax Number	:	513-686-6868

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

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	01/13/2026

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