Provider Demographics
NPI:1407818156
Name:COHN, JESSICA MARGARET (MD)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARGARET
Last Name:COHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 VILLAGE BLVD
Mailing Address - Street 2:SUITE #202
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-687-9633
Mailing Address - Fax:561-684-5969
Practice Address - Street 1:603 VILLAGE BLVD
Practice Address - Street 2:SUITE #202
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-687-9633
Practice Address - Fax:561-684-5969
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME561862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3000615677OtherMEDICARE RAILROAD
FL3000615677OtherMEDICARE RAILROAD
FLK2741Medicare PIN