Provider Demographics
NPI:1437361359
Name:COHEN, JEFFREY RICHARD (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:RICHARD
Last Name:COHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 TOWN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-7026
Mailing Address - Country:US
Mailing Address - Phone:862-812-0668
Mailing Address - Fax:
Practice Address - Street 1:26 W MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2243
Practice Address - Country:US
Practice Address - Phone:845-896-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT005214152W00000X
NJ27OA00553500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist