MEDICARE: PAUL A COHEN DDS

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	122300000X	Dentist	DS018840L	PA

General Provider Information

NPI Number	:	1396894606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL A COHEN DDS

Provider Business Mailing Address
First Line	:	6808 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19135
Country	:	US
Telephone Number	:	215-624-7418
Fax Number	:	215-624-5499

Provider Business Practice Location Address
First Line	:	6808 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19135
Country	:	US
Telephone Number	:	215-624-7418
Fax Number	:	215-624-5499

Authorized Official
Title or Position	:	DENTIST OWNER
Name	:	DR. PAUL A COHEN
Credential	:
Telephone Number	:	215-624-7418

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/22/2020

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