Provider Demographics
NPI:1598756231
Name:COHEN, GLENN R (DO)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:R
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:123 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1382
Mailing Address - Country:US
Mailing Address - Phone:610-278-7456
Mailing Address - Fax:610-278-7457
Practice Address - Street 1:123 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1382
Practice Address - Country:US
Practice Address - Phone:610-278-7456
Practice Address - Fax:610-278-7457
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2015-02-10
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Provider Licenses
StateLicense IDTaxonomies
PA012264207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094198Medicare ID - Type Unspecified