Provider Demographics
NPI:1578527180
Name:RORY COHEN DPM PC
Entity Type:Organization
Organization Name:RORY COHEN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-797-3668
Mailing Address - Street 1:578 HENRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2706
Mailing Address - Country:US
Mailing Address - Phone:718-797-3668
Mailing Address - Fax:718-802-7120
Practice Address - Street 1:420 FULTON ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5214
Practice Address - Country:US
Practice Address - Phone:718-797-3668
Practice Address - Fax:718-802-7120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004877-A21213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01259094Medicaid
NY01259094Medicaid
NY1175690001Medicare NSC
NYWTW321Medicare PIN