Provider Demographics
NPI:1316396294
Name:COHEN, MELISSA FAYE
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:FAYE
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 MARCUS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1028
Mailing Address - Country:US
Mailing Address - Phone:516-467-8600
Mailing Address - Fax:929-455-9855
Practice Address - Street 1:1999 MARCUS AVE STE 102
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1028
Practice Address - Country:US
Practice Address - Phone:516-467-8600
Practice Address - Fax:929-455-9855
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312413207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty