Provider Demographics
NPI:1003932831
Name:BART COHEN P.A.
Entity Type:Organization
Organization Name:BART COHEN P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-835-2794
Mailing Address - Street 1:27 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1709
Mailing Address - Country:US
Mailing Address - Phone:973-835-2794
Mailing Address - Fax:973-839-7308
Practice Address - Street 1:27 COLFAX AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1709
Practice Address - Country:US
Practice Address - Phone:973-835-2794
Practice Address - Fax:973-839-7308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00158700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2057701Medicaid
NJ4384760001Medicare NSC
NJ006127Medicare PIN
NJ2057701Medicaid