Provider Demographics
NPI:1750502001
Name:COHEN, PHYLLIS F (PHD, PSYD, FAGPA)
Entity Type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:F
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD, PSYD, FAGPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 57TH ST
Mailing Address - Street 2:SUITE 20 CD
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3114
Mailing Address - Country:US
Mailing Address - Phone:212-489-7607
Mailing Address - Fax:212-582-8087
Practice Address - Street 1:301 W 57TH ST
Practice Address - Street 2:SUITE 20 CD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3114
Practice Address - Country:US
Practice Address - Phone:212-489-7607
Practice Address - Fax:212-582-8087
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000445-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst