Provider Demographics
NPI:1710170352
Name:COHEN, ZIV EZRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIV
Middle Name:EZRA
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 57TH ST STE 304
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3262
Mailing Address - Country:US
Mailing Address - Phone:212-335-0236
Mailing Address - Fax:
Practice Address - Street 1:200 W 57TH ST STE 304
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3262
Practice Address - Country:US
Practice Address - Phone:212-335-0236
Practice Address - Fax:646-607-5985
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY602419352084F0202X
NY2419352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08A021Medicare PIN