Provider Demographics
NPI:1235100157
Name:COHEN, ANDREW (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
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 1:17 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4502
Mailing Address - Country:US
Mailing Address - Phone:718-966-6869
Mailing Address - Fax:718-989-6995
Practice Address - Street 1:711B SEAGIRT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5730
Practice Address - Country:US
Practice Address - Phone:718-966-6869
Practice Address - Fax:718-989-6995
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005225213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU63962Medicare UPIN
NYP25681Medicare ID - Type Unspecified
NY0573AMedicare ID - Type Unspecified