Provider Demographics
NPI:1033184601
Name:COHEN, DANIEL
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1564
Mailing Address - Country:US
Mailing Address - Phone:914-428-2120
Mailing Address - Fax:
Practice Address - Street 1:3030 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2574
Practice Address - Country:US
Practice Address - Phone:914-607-6260
Practice Address - Fax:914-607-6261
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2099941208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01818322Medicaid
NY01818322Medicaid
NY6B4001Medicare ID - Type Unspecified