Provider Demographics
NPI:1275759318
Name:COHEN, DEIRDRE JILL (MD)
Entity Type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:JILL
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 GREENWICH ST
Mailing Address - Street 2:APT 6G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2076
Mailing Address - Country:US
Mailing Address - Phone:917-940-9786
Mailing Address - Fax:
Practice Address - Street 1:160 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4750
Practice Address - Country:US
Practice Address - Phone:212-731-5196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229383207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02ABO1Medicare PIN