Provider Demographics
NPI:1386008738
Name:COHEN, GAIL ROBIN (MSED)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ROBIN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 DIEMAN LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4820
Mailing Address - Country:US
Mailing Address - Phone:516-565-1120
Mailing Address - Fax:
Practice Address - Street 1:1521 DIEMAN LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-4820
Practice Address - Country:US
Practice Address - Phone:516-565-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherCERTIFICATION