MEDICARE: DR. ADAM JONATHAN 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	238190	NY
2	2084P0804X	Child & Adolescent Psychiatry Physician	238190	NY

General Provider Information

NPI Number	:	1285873844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM JONATHAN COHEN M.D.

Provider Business Mailing Address
First Line	:	16 W 16TH ST
Second Line	:	APT #11NN
City	:	NEW YORK
State	:	NY
Zip	:	10011-6328
Country	:	US
Telephone Number	:	516-650-2318
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 W 16TH ST
Second Line	:	APT #11NN
City	:	NEW YORK
State	:	NY
Zip	:	10011-6328
Country	:	US
Telephone Number	:	516-650-2318
Fax Number	:

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

Provider Enumeration Date	:	02/05/2009
Last Update Date	:	02/05/2009

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