MEDICARE: CARYN M COHEN PA-C

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	363AM0700X	Medical Physician Assistant	MA000551L	PA

General Provider Information

NPI Number	:	1821171547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARYN M COHEN PA-C

Provider Business Mailing Address
First Line	:	224 LORRAINE AVE
Second Line	:
City	:	ORELAND
State	:	PA
Zip	:	19075-1702
Country	:	US
Telephone Number	:	215-884-2640
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 RIDGE AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19128-1737
Country	:	US
Telephone Number	:	215-483-9900
Fax Number	:

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	06/13/2012

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Directions to “ CARYN M COHEN PA-C” Practice Location

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