Provider Demographics
NPI:1093811440
Name:COHEN CHIROPRACTIC CENTER PA
Entity Type:Organization
Organization Name:COHEN CHIROPRACTIC CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-794-3311
Mailing Address - Street 1:14 23 RIVER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1240
Mailing Address - Country:US
Mailing Address - Phone:201-794-3311
Mailing Address - Fax:201-794-7318
Practice Address - Street 1:14 23 RIVER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1240
Practice Address - Country:US
Practice Address - Phone:201-794-3311
Practice Address - Fax:201-794-7318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00219900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
=========OtherTAX ID
V24664Medicare UPIN