Provider Demographics
NPI:1497185524
Name:COHEN, SAMARA
Entity Type:Individual
Prefix:
First Name:SAMARA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 W END AVE APT E11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3554
Mailing Address - Country:US
Mailing Address - Phone:646-370-6546
Mailing Address - Fax:
Practice Address - Street 1:936 W END AVE APT E11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3554
Practice Address - Country:US
Practice Address - Phone:646-370-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist