Provider Demographics
NPI:1740211382
Name:COHEN, ILONA D (MD)
Entity Type:Individual
Prefix:DR
First Name:ILONA
Middle Name:D
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ILONA
Other - Middle Name:D
Other - Last Name:GINSBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 GUSTAVE L. LEVY PLACE
Mailing Address - Street 2:BOX 1194
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-8395
Mailing Address - Fax:212-289-0092
Practice Address - Street 1:10 UNION SQUARE EAST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-844-8880
Practice Address - Fax:212-844-6807
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1946342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG79676Medicare UPIN
NY02136189Medicaid
NY465S91Medicare PIN