Provider Demographics
NPI:1568575900
Name:COHEN, WENDY BEYER (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:BEYER
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:BEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:508-350-2450
Mailing Address - Fax:508-350-2319
Practice Address - Street 1:21 BRISTOL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02375-1199
Practice Address - Country:US
Practice Address - Phone:508-565-7300
Practice Address - Fax:508-565-7335
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00099207Q00000X
RIMD12266207Q00000X
MA237040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001057402OtherMEDICARE PTAN
MA700J44574OtherBC/BS
MA062268OtherTUFTS
MAAA142191OtherHPHC
MA062268OtherTUFTS
MA700J44574OtherBC/BS
RI411833Medicare Oscar/Certification