Provider Demographics
NPI:1790724300
Name:COHEN, SHIRLEY K (CNM)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:K
Last Name:COHEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 PROSPECT ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5020
Mailing Address - Country:US
Mailing Address - Phone:732-942-4442
Mailing Address - Fax:732-942-7024
Practice Address - Street 1:101 PROSPECT ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5020
Practice Address - Country:US
Practice Address - Phone:732-942-4442
Practice Address - Fax:732-942-7024
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25ME00035200367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife