Provider Demographics
NPI:1326370321
Name:COHEN, ALBERT SAMUEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:SAMUEL
Last Name:COHEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10807 CORONA AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3941
Mailing Address - Country:US
Mailing Address - Phone:718-699-7171
Mailing Address - Fax:718-699-7554
Practice Address - Street 1:10807 CORONA AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3941
Practice Address - Country:US
Practice Address - Phone:718-699-7171
Practice Address - Fax:718-699-7554
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist