Provider Demographics
NPI:1669446464
Name:COHEN, MELISSA DAWNE (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWNE
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:297 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-1502
Mailing Address - Country:US
Mailing Address - Phone:516-294-1377
Mailing Address - Fax:516-294-5574
Practice Address - Street 1:297 MINEOLA BLVD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-1502
Practice Address - Country:US
Practice Address - Phone:516-294-1377
Practice Address - Fax:516-294-5574
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY203789207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15U201Medicare PIN
G35108Medicare UPIN