MEDICARE: MS. JODI ANNE 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	225XP0200X	Pediatric Occupational Therapist	012017	NY

General Provider Information

NPI Number	:	1780828822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JODI ANNE COHEN OTR/L

Provider Business Mailing Address
First Line	:	323 E 91ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-5937
Country	:	US
Telephone Number	:	212-828-2710
Fax Number	:

Provider Business Practice Location Address
First Line	:	323 E 91ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-5937
Country	:	US
Telephone Number	:	212-828-2710
Fax Number	:

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

Provider Enumeration Date	:	04/20/2009
Last Update Date	:	11/02/2020

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