Provider Demographics
NPI:1437122942
Name:COHEN, MINDY (APRN, C, CGP, DRCC)
Entity Type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:APRN, C, CGP, DRCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FOX HUNT DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831
Mailing Address - Country:US
Mailing Address - Phone:732-439-9972
Mailing Address - Fax:732-605-1840
Practice Address - Street 1:2 FOX HUNT DRIVE
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:732-439-9972
Practice Address - Fax:732-605-1840
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC06225000364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6631801Medicaid