Provider Demographics
NPI:1386649838
Name:COHN, STUART S (OD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:S
Last Name:COHN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-3114
Mailing Address - Country:US
Mailing Address - Phone:610-921-9200
Mailing Address - Fax:610-929-1533
Practice Address - Street 1:500 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-3114
Practice Address - Country:US
Practice Address - Phone:610-921-9200
Practice Address - Fax:610-929-1533
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000941152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015710220004Medicaid
PA0015710220004Medicaid
PA284098LLQMedicare ID - Type Unspecified