Provider Demographics
NPI:1609124908
Name:COHEN, ADAM M (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:M
Last Name:COHEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HUDSON ST
Mailing Address - Street 2:APT. 603
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5854
Mailing Address - Country:US
Mailing Address - Phone:860-670-2669
Mailing Address - Fax:
Practice Address - Street 1:322 STOCKHOLM ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3902
Practice Address - Country:US
Practice Address - Phone:718-366-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0548801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics