Provider Demographics
NPI:1851573935
Name:LAURA COHEN PA
Entity Type:Organization
Organization Name:LAURA COHEN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,PA
Authorized Official - Phone:954-893-7110
Mailing Address - Street 1:2699 STIRLING RD
Mailing Address - Street 2:SUITE C403C
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6517
Mailing Address - Country:US
Mailing Address - Phone:954-893-7110
Mailing Address - Fax:954-893-1105
Practice Address - Street 1:2699 STIRLING RD
Practice Address - Street 2:SUITE C403C
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6517
Practice Address - Country:US
Practice Address - Phone:954-893-7110
Practice Address - Fax:954-893-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7909Medicare UPIN