Provider Demographics
NPI:1972508539
Name:COHEN, IRA S (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:925 CHESTNUT STREET
Mailing Address - Street 2:MEZZANINE FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4201
Mailing Address - Country:US
Mailing Address - Phone:215-955-5050
Mailing Address - Fax:215-955-7499
Practice Address - Street 1:925 CHESTNUT STREET
Practice Address - Street 2:MEZZANINE FLOOR - JEFFERSON HEART INSTITUTE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4201
Practice Address - Country:US
Practice Address - Phone:215-955-5050
Practice Address - Fax:215-955-7499
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2014-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD073791207RC0000X
NJ25MA09417000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0133884Medicaid
PA001875761Medicaid
PAD72615Medicare UPIN
PA050704Medicare PIN