Provider Demographics
NPI:1760420517
Name:COTZEN, DONNA J (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:COTZEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:210 LOCUST ST
Mailing Address - Street 2:APT 4A
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3934
Mailing Address - Country:US
Mailing Address - Phone:215-592-9874
Mailing Address - Fax:215-238-1260
Practice Address - Street 1:325 CHESTNUT ST
Practice Address - Street 2:SUITE 905
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19106-2614
Practice Address - Country:US
Practice Address - Phone:215-238-1262
Practice Address - Fax:215-238-1260
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2012-01-30
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Provider Licenses
StateLicense IDTaxonomies
PAMD017885E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA093405Medicare ID - Type Unspecified