Provider Demographics
NPI:1639596240
Name:SUSAN E. COHEN MSN APN LLC
Entity Type:Organization
Organization Name:SUSAN E. COHEN MSN APN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN APN
Authorized Official - Phone:856-691-1511
Mailing Address - Street 1:1138 E CHESTNUT AVE
Mailing Address - Street 2:BLDG 6-B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5053
Mailing Address - Country:US
Mailing Address - Phone:856-691-1511
Mailing Address - Fax:856-691-8511
Practice Address - Street 1:1138 E CHESTNUT AVE
Practice Address - Street 2:BLDG 6-B
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5053
Practice Address - Country:US
Practice Address - Phone:856-691-1511
Practice Address - Fax:856-691-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06037300363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty