Provider Demographics
NPI:1518043454
Name:COHEN, MICHAEL I (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:I
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KINGS CT
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3527
Mailing Address - Country:US
Mailing Address - Phone:718-920-4045
Mailing Address - Fax:718-654-6692
Practice Address - Street 1:MMC - DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:111 E. 210TH STREET CENT. 1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086106208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics