Provider Demographics
NPI:1376840454
Name:COHEN, WARREN MARTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:MARTIN
Last Name:COHEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1103
Mailing Address - Country:US
Mailing Address - Phone:212-987-2717
Mailing Address - Fax:212-987-7681
Practice Address - Street 1:110 E 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1103
Practice Address - Country:US
Practice Address - Phone:212-987-2717
Practice Address - Fax:212-987-7681
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011070-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical