Provider Demographics
NPI:1942361969
Name:COHEN, FREDERICK B (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:B
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 BEECHSPRING RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1510
Mailing Address - Country:US
Mailing Address - Phone:973-926-7230
Mailing Address - Fax:973-926-9568
Practice Address - Street 1:292 BEECHSPRING RD
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1510
Practice Address - Country:US
Practice Address - Phone:973-926-7230
Practice Address - Fax:973-926-9568
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA15277207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA15277OtherSTATE LICENSE
NJ2428300Medicaid
NJAC1545827OtherDEA
NJC55893Medicare UPIN
NJ25MA15277OtherSTATE LICENSE