MEDICARE: DR. BETH A 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	2084N0400X	Neurology Physician	MD-048450-L	PA

General Provider Information

NPI Number	:	1902901135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETH A COHEN M.D.

Provider Business Mailing Address
First Line	:	371 E BROWN ST
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18301-9101
Country	:	US
Telephone Number	:	570-424-1864
Fax Number	:	570-424-5774

Provider Business Practice Location Address
First Line	:	371 E BROWN ST
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18301-9101
Country	:	US
Telephone Number	:	570-424-1864
Fax Number	:	570-424-5774

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/08/2007

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