Provider Demographics
NPI:1154312346
Name:COHEN, JEFFREY S (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:FAULKNER HOSPITAL CARDIOLOGY DIVISION STE 4955
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-7541
Mailing Address - Fax:617-983-4558
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:FAULKNER HOSPITAL CARDIOLOGY DIVISION STE 4955
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-983-7541
Practice Address - Fax:617-983-4558
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2009-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA77606207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA22773Medicare ID - Type Unspecified