Provider Demographics
NPI:1467435081
Name:COHEN, MICHAEL SAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SAM
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:575 UNDERHILL BLVD STE 175
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3417
Mailing Address - Country:US
Mailing Address - Phone:516-921-6780
Mailing Address - Fax:516-921-9176
Practice Address - Street 1:575 UNDERHILL BLVD STE 175
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3417
Practice Address - Country:US
Practice Address - Phone:516-921-6780
Practice Address - Fax:516-921-9176
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2023-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY207896207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH15089Medicare UPIN