Provider Demographics
NPI:1851883805
Name:COHEN, LAURA MARIE
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:MARIE
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E 74TH ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3722
Mailing Address - Country:US
Mailing Address - Phone:631-848-0890
Mailing Address - Fax:
Practice Address - Street 1:404 E 91ST ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6807
Practice Address - Country:US
Practice Address - Phone:212-369-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist