Provider Demographics
NPI:1073551800
Name:COHEN, BARRY A (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:A
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:PO BOX 4059
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07474-4059
Mailing Address - Country:US
Mailing Address - Phone:973-826-8285
Mailing Address - Fax:855-834-5436
Practice Address - Street 1:695 US HIGHWAY 46
Practice Address - Street 2:SUITE 400A
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1592
Practice Address - Country:US
Practice Address - Phone:973-826-8080
Practice Address - Fax:866-309-3354
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0291500174400000X
NJ25MA02915000207VG0400X, 208600000X
FLME119433208600000X
NY125434208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0660302Medicaid
NJP3942465OtherOXFORD HEALTHCARE
NJ146573YP69OtherGRP PTAN QUALITY SURGICAL SERVICES LLC
NJ275286YP69OtherBAC MCARE PIN
NJ3740947000OtherAMERIHEALTH
NJ0543004OtherCIGNA
NJ146573Medicare PIN
NJ146573YP69OtherGRP PTAN QUALITY SURGICAL SERVICES LLC
NJ91000573702OtherAMERICHOICE MEDICAID HMO
NJD90487Medicare UPIN
NJ100194856604OtherAMERICHOICE MEDICAID HMO
NJ146573ZCK8Medicare PIN
NJ1790731271OtherGRP NPI COMPREHENSIVE WOMEN'S HEALTHCARE
NJ1942321070OtherGRP NPI SURGAIDE 1, LLC
NJ3740947000OtherAMERIHEALTH
NJP3942465OtherOXFORD HEALTHCARE