Provider Demographics
NPI:1134159684
Name:COHEN, SETH
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 2ND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2746
Mailing Address - Country:US
Mailing Address - Phone:212-734-8874
Mailing Address - Fax:212-249-5628
Practice Address - Street 1:305 2ND AVE STE 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2746
Practice Address - Country:US
Practice Address - Phone:212-734-8874
Practice Address - Fax:212-249-5628
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172654207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01416302Medicaid
NY82F58ZVZP1Medicare PIN
NYE86331Medicare UPIN