Provider Demographics
NPI:1528025194
Name:ABRAHAM-COHEN, JYOTHIS A (OD)
Entity Type:Individual
Prefix:DR
First Name:JYOTHIS
Middle Name:A
Last Name:ABRAHAM-COHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BROUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3989
Mailing Address - Country:US
Mailing Address - Phone:973-743-1331
Mailing Address - Fax:973-743-6577
Practice Address - Street 1:108 BROUGHTON AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3989
Practice Address - Country:US
Practice Address - Phone:973-743-1331
Practice Address - Fax:973-743-6577
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27AO00569600152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU71836Medicare UPIN
NJ098289CAHMedicare ID - Type Unspecified