Provider Demographics
NPI:1073605259
Name:GORDON-COHEN, BARBARA (DO)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:GORDON-COHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BOAR CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-1402
Mailing Address - Country:US
Mailing Address - Phone:845-354-4507
Mailing Address - Fax:845-354-4508
Practice Address - Street 1:4 BOAR CT
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-1402
Practice Address - Country:US
Practice Address - Phone:845-354-4507
Practice Address - Fax:845-354-4508
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF30584Medicare UPIN
NY69F111Medicare ID - Type Unspecified