Provider Demographics
NPI:1437222494
Name:COHEN, BEHNAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:BEHNAM
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 15 MAIN STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:718-658-8341
Mailing Address - Fax:718-570-0018
Practice Address - Street 1:85 15 MAIN STREET
Practice Address - Street 2:SUITE C
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:718-658-8341
Practice Address - Fax:718-570-0018
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044916122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01448484Medicaid