Provider Demographics
NPI:1275527707
Name:COHEN, BARRY MARK (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:MARK
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:PRACTICE ASSOCIATES MEDICAL GROUP
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:211 MOUNTAIN AVE
Practice Address - Street 2:ASSOCIATES IN CARDIOVASCULAR DISEASE, LLC
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081
Practice Address - Country:US
Practice Address - Phone:973-467-0005
Practice Address - Fax:973-912-8989
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2018-09-06
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05169900207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0679003Medicaid
NJ579406U77Medicare PIN
E51540Medicare UPIN
NJ0679003Medicaid