Provider Demographics
NPI:1639216807
Name:COHEN, BARRY V (DC)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:V
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-3639
Mailing Address - Country:US
Mailing Address - Phone:631-696-1515
Mailing Address - Fax:
Practice Address - Street 1:227 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-3639
Practice Address - Country:US
Practice Address - Phone:631-696-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002629-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC026296OtherWORKER'S COMP
NYX16071Medicare PIN
NY08356HMedicare PIN