Provider Demographics
NPI:1427197268
Name:HAZAN COHEN, HELEN (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:
Last Name:HAZAN COHEN
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:MS
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:HAZAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:492 CARPENTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572
Mailing Address - Country:US
Mailing Address - Phone:516-208-3898
Mailing Address - Fax:
Practice Address - Street 1:492 CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572
Practice Address - Country:US
Practice Address - Phone:516-208-3898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03181311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01596294Medicaid
NY01596294Medicaid