Provider Demographics
NPI:1669655262
Name:RICHARD S COHEN DPM PA
Entity Type:Organization
Organization Name:RICHARD S COHEN DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-345-4087
Mailing Address - Street 1:7525 GRENNWAY CENTER DRIVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3525
Mailing Address - Country:US
Mailing Address - Phone:301-345-4087
Mailing Address - Fax:
Practice Address - Street 1:7525 GRENNWAY CENTER DRIVE
Practice Address - Street 2:SUITE 112
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3525
Practice Address - Country:US
Practice Address - Phone:301-345-4087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00654213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043273451Medicare PIN
1376549345Medicare PIN