Provider Demographics
NPI:1821455650
Name:COHEN, DANIEL RICARDO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICARDO
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 1:400A LAKE ST
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1367
Mailing Address - Country:US
Mailing Address - Phone:201-825-0186
Mailing Address - Fax:201-825-0191
Practice Address - Street 1:400A LAKE ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1367
Practice Address - Country:US
Practice Address - Phone:201-825-0186
Practice Address - Fax:201-825-0191
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MS00017500170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics