Provider Demographics
NPI:1124607387
Name:COHN, ELLERY REBECCA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLERY
Middle Name:REBECCA
Last Name:COHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9032
Mailing Address - Country:US
Mailing Address - Phone:214-648-2986
Mailing Address - Fax:214-648-4566
Practice Address - Street 1:5323 HARRY HINES BLVD DEPT OF
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9032
Practice Address - Country:US
Practice Address - Phone:214-648-2986
Practice Address - Fax:214-648-4566
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program