Provider Demographics
NPI:1821281684
Name:LAWRENCE M. COHEN, DPM,INC
Entity Type:Organization
Organization Name:LAWRENCE M. COHEN, DPM,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-494-4949
Mailing Address - Street 1:1515 PORTAGE ST NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2290
Mailing Address - Country:US
Mailing Address - Phone:330-494-4949
Mailing Address - Fax:330-494-4945
Practice Address - Street 1:1515 PORTAGE ST NW
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2290
Practice Address - Country:US
Practice Address - Phone:330-494-4949
Practice Address - Fax:330-494-4945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0143964Medicaid
OH9301131Medicare PIN
OH0571510001Medicare NSC