Provider Demographics
NPI:1942494810
Name:COHEN, ELLIOT SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:SAMUEL
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:681NE30TH PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6947
Mailing Address - Country:US
Mailing Address - Phone:561-955-8866
Mailing Address - Fax:561-955-8866
Practice Address - Street 1:15300 S JOG RD
Practice Address - Street 2:108
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2162
Practice Address - Country:US
Practice Address - Phone:561-742-5959
Practice Address - Fax:561-734-2226
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME O36592207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D67334Medicare UPIN