MEDICARE: JILL COHEN

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	101YM0800X	Mental Health Counselor	44SC05639200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194107904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL COHEN

Provider Business Mailing Address
First Line	:	49 E MIDLAND AVE
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-2920
Country	:	US
Telephone Number	:	973-464-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 OAKLAND CT
Second Line	:
City	:	RAMSEY
State	:	NJ
Zip	:	07446-1176
Country	:	US
Telephone Number	:	973-464-1111
Fax Number	:

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

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	06/29/2015

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