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NPI Code Detail

MEDICARE: SASHA COHEN MALCOLM ATR-BC, LCAT

MEDICARE: SASHA COHEN MALCOLM ATR-BC, LCAT
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
1246ZA2600XMedical Art Specialist/Technologist05-001799NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001799OTHERNYLICENSE IN CREATIVE ARTS THERAPY
215-063OTHERART THERAPY CREDENTIALS BOARD

General Provider Information

NPI Number : 1467997114
Entity Type Code : Individual
Provider Name (Legal Business Name) : SASHA COHEN MALCOLM ATR-BC, LCAT
Provider Business Mailing Address
First Line : 1125 FULTON ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-2669
Country : US
Telephone Number : 347-226-0925
Fax Number :
Provider Business Practice Location Address
First Line : 1125 FULTON ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-2669
Country : US
Telephone Number : 347-226-9025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2017
Last Update Date : 09/29/2021

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