Provider Demographics
NPI:1427379155
Name:COHLER, MARISSA H (MD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:H
Last Name:COHLER
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 1:1250 HANCOCK ST STE 501N
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4486
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:844-840-3974
Practice Address - Street 1:1250 HANCOCK ST STE 501N
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4486
Practice Address - Country:US
Practice Address - Phone:800-835-2362
Practice Address - Fax:844-840-3974
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-057412208100000X
IL036135846208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation