Provider Demographics
NPI:1568583011
Name:COHEN FASHION OPTICAL
Entity Type:Organization
Organization Name:COHEN FASHION OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:TRITY
Authorized Official - Suffix:
Authorized Official - Credentials:RDO
Authorized Official - Phone:603-888-6500
Mailing Address - Street 1:310 DANIEL WEBSTER HIGHWAY
Mailing Address - Street 2:#232
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-888-6500
Mailing Address - Fax:603-888-1514
Practice Address - Street 1:310 DANIEL WEBSTER HIGHWAY
Practice Address - Street 2:#232
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-888-6500
Practice Address - Fax:603-888-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH194 NH156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04321OtherSPECTERA
NH111580OtherEYE MED