Provider Demographics
NPI:1972754703
Name:RHODA H COBIN MD PA
Entity Type:Organization
Organization Name:RHODA H COBIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:H
Authorized Official - Last Name:COBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-444-7465
Mailing Address - Street 1:75 N MAPLE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3262
Mailing Address - Country:US
Mailing Address - Phone:201-444-7465
Mailing Address - Fax:201-444-4490
Practice Address - Street 1:75 N MAPLE AVE STE 202
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3262
Practice Address - Country:US
Practice Address - Phone:201-444-7465
Practice Address - Fax:201-444-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02870000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ513675Medicare UPIN