Provider Demographics
NPI:1083780407
Name:COHEN, STEVEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:292 BUCHANAN TRAIL
Mailing Address - City:MCCONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233
Mailing Address - Country:US
Mailing Address - Phone:717-987-4111
Mailing Address - Fax:717-987-4311
Practice Address - Street 1:292 BUCHANAN TRAIL
Practice Address - Street 2:
Practice Address - City:MCCONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233
Practice Address - Country:US
Practice Address - Phone:717-987-4111
Practice Address - Fax:717-987-4311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039991L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010419660004Medicaid
C0157759OtherBCBS
PAB 96850Medicare UPIN