Provider Demographics
NPI:1609987908
Name:COHEN, SYDNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5099
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-5099
Mailing Address - Country:US
Mailing Address - Phone:912-882-3662
Mailing Address - Fax:912-882-7720
Practice Address - Street 1:10545 COLERAIN RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3720
Practice Address - Country:US
Practice Address - Phone:912-882-3662
Practice Address - Fax:912-882-7720
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0422162084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10590056OtherCAQH
GA52508263OtherBCBS GA
GA26BDGDZMedicare ID - Type Unspecified
GA52508263OtherBCBS GA