Provider Demographics
NPI:1225082597
Name:COHN, STEVEN J (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:COHN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:4998 STATE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4626
Mailing Address - Country:US
Mailing Address - Phone:610-259-5100
Mailing Address - Fax:610-259-4133
Practice Address - Street 1:4998 STATE ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4626
Practice Address - Country:US
Practice Address - Phone:610-259-5100
Practice Address - Fax:610-259-4133
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2008-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG000152152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0293540001Medicare NSC
PAT30036Medicare UPIN
PA188009Medicare PIN