Provider Demographics
NPI:1417089731
Name:DEBORAH COEN M.D. PSYCHIATRIC SERVICES L.L.C.
Entity Type:Organization
Organization Name:DEBORAH COEN M.D. PSYCHIATRIC SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:COEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-746-3330
Mailing Address - Street 1:10709 WAYZATA BLVD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5509
Mailing Address - Country:US
Mailing Address - Phone:952-746-3330
Mailing Address - Fax:952-545-2652
Practice Address - Street 1:10709 WAYZATA BLVD
Practice Address - Street 2:SUITE 245
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5509
Practice Address - Country:US
Practice Address - Phone:952-746-3330
Practice Address - Fax:952-545-2652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN404532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNG72938Medicare UPIN