MEDICARE: DANA G 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	207R00000X	Internal Medicine Physician	224153	MA
2	207R00000X	Internal Medicine Physician	211593	NY

General Provider Information

NPI Number	:	1376582361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA G COHEN M.D.

Provider Business Mailing Address
First Line	:	10 W 74TH ST
Second Line	:	APT. 1D
City	:	NEW YORK
State	:	NY
Zip	:	10023-2403
Country	:	US
Telephone Number	:	212-787-1877
Fax Number	:	212-787-1667

Provider Business Practice Location Address
First Line	:	10 W 74TH ST
Second Line	:	APT. 1D
City	:	NEW YORK
State	:	NY
Zip	:	10023-2403
Country	:	US
Telephone Number	:	212-787-1877
Fax Number	:	212-787-1667

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	05/01/2013

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Directions to “ DANA G COHEN M.D.” Practice Location

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