MEDICARE: DR. LAWRENCE WILLIAM COHEN DDS

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	122300000X	Dentist	26869	NY

General Provider Information

NPI Number	:	1942431531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE WILLIAM COHEN DDS

Provider Business Mailing Address
First Line	:	11 TANGLEWOOD DR
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-1221
Country	:	US
Telephone Number	:	845-297-6521
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-4069
Country	:	US
Telephone Number	:	212-998-9477
Fax Number	:

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

Provider Enumeration Date	:	07/31/2009
Last Update Date	:	07/31/2009

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