Provider Demographics
NPI:1801223813
Name:COHEN, ANDREA (LAC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1000
Mailing Address - Country:US
Mailing Address - Phone:914-472-2600
Mailing Address - Fax:914-722-1763
Practice Address - Street 1:531 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1000
Practice Address - Country:US
Practice Address - Phone:914-472-2600
Practice Address - Fax:914-722-1763
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003198-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist