Provider Demographics
NPI:1225281231
Name:COHEN, BARRY JAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:JAY
Last Name:COHEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SAINT PAUL LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-9374
Mailing Address - Country:US
Mailing Address - Phone:949-496-6766
Mailing Address - Fax:949-248-1999
Practice Address - Street 1:27220 HEATHER RIDGE RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3418
Practice Address - Country:US
Practice Address - Phone:949-389-8702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist