Provider Demographics
NPI:1841561156
Name:JEFFREY R. COHEN, D.C.,P.A.
Entity Type:Organization
Organization Name:JEFFREY R. COHEN, D.C.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC,PA
Authorized Official - Phone:561-967-1950
Mailing Address - Street 1:5891 S MILITARY TRL
Mailing Address - Street 2:3-A
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6920
Mailing Address - Country:US
Mailing Address - Phone:561-967-1950
Mailing Address - Fax:561-967-3735
Practice Address - Street 1:5891 S MILITARY TRL
Practice Address - Street 2:3-A
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6920
Practice Address - Country:US
Practice Address - Phone:561-967-1950
Practice Address - Fax:561-967-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty