Provider Demographics
NPI:1629110481
Name:COHEN, ALAN BRUCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:BRUCE
Last Name:COHEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HOLIDAY MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-3910
Mailing Address - Country:US
Mailing Address - Phone:845-796-2731
Mailing Address - Fax:845-794-0170
Practice Address - Street 1:524 BROADWAY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1154
Practice Address - Country:US
Practice Address - Phone:845-794-2345
Practice Address - Fax:845-794-0170
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist