MEDICARE: LEWIS J 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	2080P0207X	Pediatric Hematology & Oncology Physician	46534	MA

General Provider Information

NPI Number	:	1093948606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEWIS J COHEN M.D.

Provider Business Mailing Address
First Line	:	2 RICHMOND DR
Second Line	:
City	:	BASKING RIDGE
State	:	NJ
Zip	:	07920-4242
Country	:	US
Telephone Number	:	908-719-9219
Fax Number	:	908-719-8725

Provider Business Practice Location Address
First Line	:	2 RICHMOND DR
Second Line	:
City	:	BASKING RIDGE
State	:	NJ
Zip	:	07920-4242
Country	:	US
Telephone Number	:	908-719-9219
Fax Number	:	908-719-8725

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

Provider Enumeration Date	:	08/30/2009
Last Update Date	:	08/30/2009

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