Provider Demographics
NPI:1164405809
Name:COHEN, HAIM (DPM)
Entity Type:Individual
Prefix:
First Name:HAIM
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 637783
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7783
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:513-853-4740
Practice Address - Street 1:4600 SMITH RD
Practice Address - Street 2:STE B
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2793
Practice Address - Country:US
Practice Address - Phone:513-221-4848
Practice Address - Fax:513-872-7825
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003318C213ES0000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2399668Medicaid
OH4101143Medicare ID - Type Unspecified
OH2399668Medicaid