Provider Demographics
NPI:1013163658
Name:SAWYER COHEN, JEANETTE (PHD)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:SAWYER COHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLAZA ST E
Mailing Address - Street 2:STE 1C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4978
Mailing Address - Country:US
Mailing Address - Phone:347-514-9654
Mailing Address - Fax:
Practice Address - Street 1:10 PLAZA ST E
Practice Address - Street 2:STE 1C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4978
Practice Address - Country:US
Practice Address - Phone:347-514-9654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019308103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical