Provider Demographics
NPI:1124052295
Name:COHEN, MARC ALAN (MD)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:ALAN
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 297
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927
Mailing Address - Country:US
Mailing Address - Phone:973-538-4444
Mailing Address - Fax:973-538-0420
Practice Address - Street 1:221 MADISON AVE.
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-538-4444
Practice Address - Fax:973-538-0420
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50155174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist