Provider Demographics
NPI:1750503363
Name:BENJAMIN N COHEN PHD PA
Entity Type:Organization
Organization Name:BENJAMIN N COHEN PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-271-3112
Mailing Address - Street 1:P.O. BOX 1546
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-1546
Mailing Address - Country:US
Mailing Address - Phone:727-271-3112
Mailing Address - Fax:
Practice Address - Street 1:1501 S PINELLAS AVE
Practice Address - Street 2:SUITE Q
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-1955
Practice Address - Country:US
Practice Address - Phone:727-271-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7056103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292384OtherAMERIGROUP
FL262432OtherCOMPSYCH
FL74425OtherBCBS
FL7247804OtherAETNA
FL328173OtherWELLCARE HARMONY BEH H
FL5628593OtherFIRST HEALTH CCN
FL5628593OtherFIRST HEALTH CCN