MEDICARE: BARRY ALAN 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	166879	NY

General Provider Information

NPI Number	:	1457398778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY ALAN COHEN M.D.

Provider Business Mailing Address
First Line	:	151A W END AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4808
Country	:	US
Telephone Number	:	718-934-1222
Fax Number	:	718-934-0552

Provider Business Practice Location Address
First Line	:	151A W END AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4808
Country	:	US
Telephone Number	:	718-934-1222
Fax Number	:	718-934-0552

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	12/24/2008

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