Provider Demographics
NPI:1992360010
Name:COHEN, JAMIE (MS,RD, CDN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MS,RD, CDN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:SHALOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2019 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2946
Mailing Address - Country:US
Mailing Address - Phone:917-972-0368
Mailing Address - Fax:
Practice Address - Street 1:2019 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2946
Practice Address - Country:US
Practice Address - Phone:917-972-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86008132133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered