Provider Demographics
NPI:1093785370
Name:COHEN, SCOTT L (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:L
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4533 NEW FALLS RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-3004
Mailing Address - Country:US
Mailing Address - Phone:267-540-8220
Mailing Address - Fax:
Practice Address - Street 1:4533 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-3004
Practice Address - Country:US
Practice Address - Phone:267-540-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008256L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2186323OtherAETNA
PA1590387Medicaid
PA30116552OtherKEYSTONE MERCY
PA0015903870008Medicaid
PA890518OtherHIGHMARK BLUE SHIELD
PA0120625000OtherKEYSTONE IBC
PA30116552OtherKEYSTONE MERCY
PA1590387Medicaid
PA2186323OtherAETNA