Provider Demographics
NPI:1861839110
Name:COHEN-HAUSMANN, ADRIANA ROSTOKER (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:ROSTOKER
Last Name:COHEN-HAUSMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:COHEN ROSTOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:55 DIMOCK ST
Mailing Address - Street 2:55 FRUIT ST.
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1029
Mailing Address - Country:US
Mailing Address - Phone:617-726-2687
Mailing Address - Fax:
Practice Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL
Practice Address - Street 2:55 FRUIT ST.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-2687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-255332208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics