Provider Demographics
NPI:1275531147
Name:COHEN, GREG E (DPM)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:E
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 1:142 JORALEMON ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4709
Mailing Address - Country:US
Mailing Address - Phone:212-481-7518
Mailing Address - Fax:718-624-7517
Practice Address - Street 1:142 JORALEMON ST
Practice Address - Street 2:STE 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4709
Practice Address - Country:US
Practice Address - Phone:718-624-3003
Practice Address - Fax:718-624-7517
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-09-11
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
NYN005886213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU92163Medicare UPIN
NYPH1531Medicare ID - Type Unspecified