Provider Demographics
NPI:1760726459
Name:COHEN, JONATHAN H (DPT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:H
Last Name:COHEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BAYBERRY CT
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3362
Mailing Address - Country:US
Mailing Address - Phone:305-775-0306
Mailing Address - Fax:
Practice Address - Street 1:112 BAYBERRY CT
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3362
Practice Address - Country:US
Practice Address - Phone:305-775-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2015-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207685225100000X
PAPT023602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist