Provider Demographics
NPI:1568682581
Name:COHEN, VALLI (MSN)
Entity Type:Individual
Prefix:
First Name:VALLI
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E LAKE SHORE TRL
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4008
Mailing Address - Country:US
Mailing Address - Phone:860-633-4047
Mailing Address - Fax:
Practice Address - Street 1:PASADENA CITY COLLEGE - STUDENT HEALTH SERVICES
Practice Address - Street 2:1570 E COLORADO BLVD D105
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106
Practice Address - Country:US
Practice Address - Phone:626-585-7244
Practice Address - Fax:626-585-7388
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000039363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner