Provider Demographics
NPI:1629047956
Name:COHEN, GREGORY LEE (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:LEE
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9201 E MOUNTAIN VIEW RD
Mailing Address - Street 2:STE 125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5198
Mailing Address - Country:US
Mailing Address - Phone:480-661-1600
Mailing Address - Fax:480-661-1809
Practice Address - Street 1:950 RYLAND ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1605
Practice Address - Country:US
Practice Address - Phone:775-329-0286
Practice Address - Fax:775-329-4243
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ24403207W00000X
NV8928207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016721Medicaid
31700Medicare ID - Type Unspecified
NV2016721Medicaid