MEDICARE: DR. IRA S COHEN MD

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	207RC0000X	Cardiovascular Disease Physician	MD073791	PA
2	207RC0000X	Cardiovascular Disease Physician	25MA09417000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972508539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRA S COHEN MD

Provider Business Mailing Address
First Line	:	925 CHESTNUT STREET
Second Line	:	MEZZANINE FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4201
Country	:	US
Telephone Number	:	215-955-5050
Fax Number	:	215-955-7499

Provider Business Practice Location Address
First Line	:	925 CHESTNUT STREET
Second Line	:	MEZZANINE FLOOR - JEFFERSON HEART INSTITUTE
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4201
Country	:	US
Telephone Number	:	215-955-5050
Fax Number	:	215-955-7499

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/05/2014

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Directions to “ DR. IRA S COHEN MD” Practice Location

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