MEDICARE: RICHARD W COHEN M.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	2084P0800X	Psychiatry Physician	MD021286E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C28261	OTHER	PA	UPIN

General Provider Information

NPI Number	:	1821052515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD W COHEN M.D.

Provider Business Mailing Address
First Line	:	2401 PENNSYLVANIA AVE
Second Line	:	SUITE 1A7
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3010
Country	:	US
Telephone Number	:	215-232-3003
Fax Number	:	215-232-5642

Provider Business Practice Location Address
First Line	:	2401 PENNSYLVANIA AVE
Second Line	:	SUITE 1A7
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3010
Country	:	US
Telephone Number	:	215-232-3003
Fax Number	:	215-232-5642

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	12/12/2007

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Directions to “ RICHARD W COHEN M.D.” Practice Location

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