MEDICARE: TAMAR ELIZABETH COHEN OTR/L

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	225X00000X	Occupational Therapist	OC018572	PA

General Provider Information

NPI Number	:	1740901305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMAR ELIZABETH COHEN OTR/L

Provider Business Mailing Address
First Line	:	1420 LOCUST ST APT 26D
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4215
Country	:	US
Telephone Number	:	203-321-5666
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 LOCUST ST APT 26D
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4215
Country	:	US
Telephone Number	:	203-321-5666
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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