Provider Demographics
NPI:1477644755
Name:COHEN, IRENE A (MD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:A
Last Name:COHEN
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 1:171 E 74TH ST
Mailing Address - Street 2:SUITE 1-1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3221
Mailing Address - Country:US
Mailing Address - Phone:212-585-1819
Mailing Address - Fax:212-585-1819
Practice Address - Street 1:171 E 74TH ST
Practice Address - Street 2:SUITE 1-1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3221
Practice Address - Country:US
Practice Address - Phone:212-585-1819
Practice Address - Fax:212-585-1819
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1550562084P0800X
TXN95292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01640986Medicaid
NYG02817Medicare UPIN
NY08M512Medicare PIN