MEDICARE: DR. HAIM VICTOR COHEN O.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	152W00000X	Optometrist	007837	NY

General Provider Information

NPI Number	:	1568725133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAIM VICTOR COHEN O.D.

Provider Business Mailing Address
First Line	:	948 E 12TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3608
Country	:	US
Telephone Number	:	347-392-2673
Fax Number	:

Provider Business Practice Location Address
First Line	:	372 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-4018
Country	:	US
Telephone Number	:	347-392-2673
Fax Number	:

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

Provider Enumeration Date	:	06/19/2012
Last Update Date	:	08/20/2012

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