MEDICARE: DR. HOWARD JAY 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	2084P0800X	Psychiatry Physician	0101041563	VA

General Provider Information

NPI Number	:	1073790705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD JAY COHEN M.D.

Provider Business Mailing Address
First Line	:	1444 DUKE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-3403
Country	:	US
Telephone Number	:	703-836-7130
Fax Number	:	703-836-6470

Provider Business Practice Location Address
First Line	:	1444 DUKE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-3403
Country	:	US
Telephone Number	:	703-836-7130
Fax Number	:	703-836-6470

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

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	01/24/2008

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