Provider Demographics
NPI:1720376601
Name:COHEN, ERIC M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:COHEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2720
Mailing Address - Country:US
Mailing Address - Phone:609-707-4282
Mailing Address - Fax:
Practice Address - Street 1:226 FOXWOOD LN
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2720
Practice Address - Country:US
Practice Address - Phone:609-707-4282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01401700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist