Provider Demographics
NPI:1780665265
Name:COHEN, TODD STUART (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:STUART
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1640 HIGHWAY 88
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3068
Mailing Address - Country:US
Mailing Address - Phone:732-840-1900
Mailing Address - Fax:732-840-0355
Practice Address - Street 1:1640 HIGHWAY 88
Practice Address - Street 2:SUITE 201
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3068
Practice Address - Country:US
Practice Address - Phone:732-840-1900
Practice Address - Fax:732-840-0355
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05544000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7041608Medicaid
NJF26781Medicare UPIN
NJ7041608Medicaid