Provider Demographics
NPI:1003951609
Name:COHEN, ELIZABETH ELLEN (PT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:COHEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6466 NW 71ST TERRACE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1216
Mailing Address - Country:US
Mailing Address - Phone:954-346-3520
Mailing Address - Fax:954-346-8040
Practice Address - Street 1:4915 COCONUT CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-972-1200
Practice Address - Fax:954-972-6212
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7510225100000X
NYPT97801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT7510OtherDIVISION OF MEDICAL QUALI
NYPT97801OtherDIVISION OF PROFESSIONAL