Provider Demographics
NPI:1407066889
Name:COHEN, ANDREW F (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:F
Last Name:COHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7407
Mailing Address - Country:US
Mailing Address - Phone:631-423-6563
Mailing Address - Fax:631-423-6585
Practice Address - Street 1:1 PEACHTREE LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7407
Practice Address - Country:US
Practice Address - Phone:631-423-6563
Practice Address - Fax:631-423-6585
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0356861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice