Provider Demographics
NPI:1922023928
Name:COHEN, RAFAEL G (PA-C)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:G
Last Name:COHEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:FBI ACADEMY
Mailing Address - Street 2:HRT BUILDING
Mailing Address - City:QUANTICO
Mailing Address - State:VA
Mailing Address - Zip Code:22135-0001
Mailing Address - Country:US
Mailing Address - Phone:703-632-1632
Mailing Address - Fax:703-632-1592
Practice Address - Street 1:FBI ACADEMY
Practice Address - Street 2:HRT BUILDING
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22135-0001
Practice Address - Country:US
Practice Address - Phone:703-632-1632
Practice Address - Fax:703-632-1592
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110003525363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant