MEDICARE: DR. DAVID Z COHAIN D.D.S.

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	19372-D067057	NJ

General Provider Information

NPI Number	:	1588857759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID Z COHAIN D.D.S.

Provider Business Mailing Address
First Line	:	555 NORTH AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2404
Country	:	US
Telephone Number	:	201-592-1818
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 NORTH AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2404
Country	:	US
Telephone Number	:	201-592-1818
Fax Number	:

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

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	08/21/2007

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