Provider Demographics
NPI:1629151105
Name:COHEN, RONALD BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:BRUCE
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 BARSTOW RD
Mailing Address - Street 2:SUITE P-10
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3501
Mailing Address - Country:US
Mailing Address - Phone:516-466-7530
Mailing Address - Fax:516-466-7531
Practice Address - Street 1:1 BARSTOW RD
Practice Address - Street 2:SUITE P-10
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3501
Practice Address - Country:US
Practice Address - Phone:516-466-7530
Practice Address - Fax:516-466-7531
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1424752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE44975Medicare UPIN
NY86A711Medicare ID - Type Unspecified