Provider Demographics
NPI:1780014571
Name:COHEN, SUZANNE VALERIE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SUZANNE
Middle Name:VALERIE
Last Name:COHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ORIENT WAY STE 204
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2086
Mailing Address - Country:US
Mailing Address - Phone:201-623-8000
Mailing Address - Fax:201-578-5160
Practice Address - Street 1:75 ORIENT WAY STE 204
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2086
Practice Address - Country:US
Practice Address - Phone:201-623-8000
Practice Address - Fax:201-578-5160
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00327900363AM0700X, 207N00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology