Provider Demographics
NPI:1508136268
Name:COHN, DEBRA (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:COHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E MAIN ST
Mailing Address - Street 2:STE 208
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1662
Mailing Address - Country:US
Mailing Address - Phone:508-393-2999
Mailing Address - Fax:508-393-3243
Practice Address - Street 1:1 E MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1662
Practice Address - Country:US
Practice Address - Phone:508-393-2999
Practice Address - Fax:508-393-3243
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09030200207V00000X
MA256895207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS40014666Medicare PIN