Provider Demographics
NPI:1861479800
Name:COHEN, JARRETT P (DC)
Entity Type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:P
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W COLD SPRING LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2831
Mailing Address - Country:US
Mailing Address - Phone:410-685-6028
Mailing Address - Fax:410-524-6608
Practice Address - Street 1:200 W COLD SPRING LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2831
Practice Address - Country:US
Practice Address - Phone:410-685-6028
Practice Address - Fax:410-524-6608
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLX90LI64720901OtherBLUE SHEILD
MDP00189239Medicare ID - Type UnspecifiedRR
MD098NMedicare ID - Type Unspecified