Provider Demographics
NPI:1033294897
Name:COHEN, ROBERTA ELLEN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ELLEN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LYNNE PL
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-1104
Mailing Address - Country:US
Mailing Address - Phone:201-666-7688
Mailing Address - Fax:
Practice Address - Street 1:15 LYNNE PL
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-1104
Practice Address - Country:US
Practice Address - Phone:201-666-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00035200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist