Provider Demographics
NPI:1417049750
Name:KOHAN, DARIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:
Last Name:KOHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 PARK AVE
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0380
Mailing Address - Country:US
Mailing Address - Phone:212-472-1300
Mailing Address - Fax:212-472-1336
Practice Address - Street 1:863 PARK AVE
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0380
Practice Address - Country:US
Practice Address - Phone:212-472-1300
Practice Address - Fax:212-472-1336
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164531207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01512409Medicaid
NYE84112Medicare UPIN
NY01512409Medicaid