MEDICARE: ERIC J COHEN DC PA

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	111N00000X	Chiropractor	CH5099	FL

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	:	1275608515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC J COHEN DC PA

Provider Business Mailing Address
First Line	:	6620 LAKE WORTH RD
Second Line	:	SUITE C
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1518
Country	:	US
Telephone Number	:	561-641-1111
Fax Number	:	561-296-0336

Provider Business Practice Location Address
First Line	:	6620 LAKE WORTH RD
Second Line	:	SUITE C
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1518
Country	:	US
Telephone Number	:	561-641-1111
Fax Number	:	561-296-0336

Authorized Official
Title or Position	:	MCC
Name	:	LAURA B BURKE
Credential	:
Telephone Number	:	954-563-4472

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	11/30/2010

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