Provider Demographics
NPI:1639647514
Name:COHEN, JANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 NASSAU TERMINAL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4997
Mailing Address - Country:US
Mailing Address - Phone:516-725-5944
Mailing Address - Fax:
Practice Address - Street 1:75 NASSAU TERMINAL RD STE 100
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4997
Practice Address - Country:US
Practice Address - Phone:888-246-3873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist