Provider Demographics
NPI:1598036816
Name:COHEN, JASON (PA-C, ATC, OTC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:PA-C, ATC, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 PRYTANIA ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3532
Mailing Address - Country:US
Mailing Address - Phone:504-899-6391
Mailing Address - Fax:
Practice Address - Street 1:3434 PRYTANIA ST
Practice Address - Street 2:SUITE 430
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3532
Practice Address - Country:US
Practice Address - Phone:504-899-6391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2001822255A2300X
11-0217246ZS0410X
LA302676363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist