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NPI Code Detail

MEDICARE: IZCHAK KOHEN MD

MEDICARE: IZCHAK KOHEN MD
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
12084P0805XGeriatric Psychiatry Physician233024NY

General Provider Information

NPI Number : 1144321167
Entity Type Code : Individual
Provider Name (Legal Business Name) : IZCHAK KOHEN MD
Provider Business Mailing Address
First Line : 7559 263RD ST
Second Line :
City : GLEN OAKS
State : NY
Zip : 11004-1150
Country : US
Telephone Number : 718-470-8011
Fax Number : 718-470-6248
Provider Business Practice Location Address
First Line : 7559 263RD ST
Second Line :
City : GLEN OAKS
State : NY
Zip : 11004-1150
Country : US
Telephone Number : 718-470-8547
Fax Number : 718-962-7712
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 07/08/2007

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