Provider Demographics
NPI:1790786499
Name:COHEN, HOWARD ROY (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:ROY
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4713 EAST TRINDLE ROAD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-737-8686
Mailing Address - Fax:717-737-8692
Practice Address - Street 1:4713 EAST TRINDLE ROAD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-737-8686
Practice Address - Fax:717-737-8692
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035112L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01062601OtherCAPITAL BLUE CROSS
PA0623527Medicaid
CO109195OtherHIGHMARK
01062601OtherCAPITAL BLUE CROSS
PA0623527Medicaid