MEDICARE: DIANA BARONE & RANDY COHEN

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	213ES0000X	Sports Medicine Podiatrist	N002790-1	NY
2	213EP1101X	Primary Podiatric Medicine Podiatrist	N003885-1	NY

General Provider Information

NPI Number	:	1962543124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANA BARONE & RANDY COHEN

Provider Business Mailing Address
First Line	:	1530 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1519
Country	:	US
Telephone Number	:	718-494-7012
Fax Number	:	718-698-9894

Provider Business Practice Location Address
First Line	:	1530 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1519
Country	:	US
Telephone Number	:	718-494-7012
Fax Number	:	718-698-9894

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DIANA BARONE
Credential	:	D.P.M.
Telephone Number	:	718-494-7012

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	08/12/2010

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Directions to “DIANA BARONE & RANDY COHEN ” Practice Location

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