Provider Demographics
NPI:1356625834
Name:KOHEN, ELIZABETH MIRNA (MS,CCC,SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MIRNA
Last Name:KOHEN
Suffix:
Gender:F
Credentials:MS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FORT WASHINGTON AVE
Mailing Address - Street 2:APT 5 F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6849
Mailing Address - Country:US
Mailing Address - Phone:917-496-4926
Mailing Address - Fax:
Practice Address - Street 1:400 FORT WASHINGTON AVE
Practice Address - Street 2:APT 5 F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6849
Practice Address - Country:US
Practice Address - Phone:917-496-4926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017187235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist