MEDICARE: MR. ARIK HYATT COHEN L.AC.

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	171100000X	Acupuncturist	25MZ00085700	NJ

General Provider Information

NPI Number	:	1649548850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARIK HYATT COHEN L.AC.

Provider Business Mailing Address
First Line	:	936 FRANKLIN LAKES RD
Second Line	:
City	:	FRANKLIN LAKES
State	:	NJ
Zip	:	07417-2153
Country	:	US
Telephone Number	:	201-847-2341
Fax Number	:

Provider Business Practice Location Address
First Line	:	936 FRANKLIN LAKES RD
Second Line	:
City	:	FRANKLIN LAKES
State	:	NJ
Zip	:	07417-2153
Country	:	US
Telephone Number	:	201-847-2341
Fax Number	:

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

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/02/2011

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