Provider Demographics
NPI:1972541282
Name:COHEN, ERIC R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:67 CODDINGTON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4511
Mailing Address - Country:US
Mailing Address - Phone:617-479-0202
Mailing Address - Fax:617-479-1692
Practice Address - Street 1:67 CODDINGTON ST
Practice Address - Street 2:INTERNAL MED & GASTROEN
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4511
Practice Address - Country:US
Practice Address - Phone:617-479-0202
Practice Address - Fax:617-479-1692
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA71361207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology