Provider Demographics
NPI:1083633622
Name:COHEN, THERESA E (PA, RN)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:E
Last Name:COHEN
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Gender:F
Credentials:PA, RN
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Mailing Address - Street 1:960 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3730
Mailing Address - Country:US
Mailing Address - Phone:203-488-6358
Mailing Address - Fax:203-481-5327
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:YALE PHYSICIANS BLDG
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-2140
Practice Address - Fax:203-785-6414
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2017-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT001664363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant