Provider Demographics
NPI:1770667354
Name:COHEN, MICHELE BETH (DC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:BETH
Last Name:COHEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:BETH
Other - Last Name:COHEN AXELROD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:527 WEST PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561
Mailing Address - Country:US
Mailing Address - Phone:516-432-7300
Mailing Address - Fax:516-431-0873
Practice Address - Street 1:527 WEST PARK AVENUE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561
Practice Address - Country:US
Practice Address - Phone:516-432-7300
Practice Address - Fax:516-431-0873
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2488111N00000X
FL3394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX14271Medicare ID - Type Unspecified