Provider Demographics
NPI:1033115712
Name:COHEN, ROBERT H (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COMMERCE ST
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1168
Mailing Address - Country:US
Mailing Address - Phone:401-793-8500
Mailing Address - Fax:401-793-8511
Practice Address - Street 1:1 COMMERCE ST
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1168
Practice Address - Country:US
Practice Address - Phone:401-793-8500
Practice Address - Fax:401-793-8511
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06840207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002147Medicaid
F13064Medicare UPIN
RI007008145Medicare PIN