Provider Demographics
NPI:1275875221
Name:COHEN, MATTHEW LAWRENCE
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LAWRENCE
Last Name:COHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEYER 218 THE JOHNS HOPKINS HOSPITAL
Mailing Address - Street 2:600 N WOLFE ST
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-955-2619
Mailing Address - Fax:410-955-0504
Practice Address - Street 1:MEYER 218 THE JOHNS HOPKINS HOSPITAL
Practice Address - Street 2:600 N WOLFE ST
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-2619
Practice Address - Fax:410-955-0504
Is Sole Proprietor?:No
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist