Provider Demographics
NPI:1326159807
Name:ROBERT K COHEN DPM PC
Entity Type:Organization
Organization Name:ROBERT K COHEN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-647-0400
Mailing Address - Street 1:250 W LANCASTER AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1762
Mailing Address - Country:US
Mailing Address - Phone:610-647-0400
Mailing Address - Fax:610-578-9590
Practice Address - Street 1:250 W LANCASTER AVE
Practice Address - Street 2:STE 220
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-647-0400
Practice Address - Fax:610-578-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004348L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01797431Medicaid
U76816Medicare UPIN
PA4687570001Medicare NSC
PA066770Medicare ID - Type Unspecified