Provider Demographics
NPI:1497795843
Name:DR. LEE S COHEN ASSOCIATES
Entity Type:Organization
Organization Name:DR. LEE S COHEN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-522-9200
Mailing Address - Street 1:642 EAST CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078
Mailing Address - Country:US
Mailing Address - Phone:610-522-9200
Mailing Address - Fax:610-522-9478
Practice Address - Street 1:642 EAST CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078
Practice Address - Country:US
Practice Address - Phone:610-522-9200
Practice Address - Fax:610-522-9478
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR LEE S COHEN ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-07
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001567L213E00000X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000707925OtherHIGHMARK BLUESHIELD ID
707925Medicare PIN
PAT72838Medicare UPIN
PA000707925OtherHIGHMARK BLUESHIELD ID
PA0895380001Medicare NSC