Provider Demographics
NPI:1245390087
Name:COHEN, SERENA (OD)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SERENA
Other - Middle Name:
Other - Last Name:SU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:301 N. LEWIS RD., SUITE 165
Mailing Address - Street 2:COLONIAL FAMILY EYECARE LLC
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1531
Mailing Address - Country:US
Mailing Address - Phone:610-948-7000
Mailing Address - Fax:610-948-7002
Practice Address - Street 1:301 N. LEWIS RD., SUITE 165
Practice Address - Street 2:COLONIAL FAMILY EYECARE LLC
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1531
Practice Address - Country:US
Practice Address - Phone:610-948-7000
Practice Address - Fax:610-948-7002
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13202152W00000X
PAOEG001519152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist