Provider Demographics
NPI:1285019562
Name:COHN, JANE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:COHN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:COHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3195
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33465-3195
Mailing Address - Country:US
Mailing Address - Phone:215-527-5094
Mailing Address - Fax:
Practice Address - Street 1:3589 S OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-5753
Practice Address - Country:US
Practice Address - Phone:215-527-5094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108830363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical