Provider Demographics
NPI:1184780538
Name:COHEN, CHARLES FRANK (OD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANK
Last Name:COHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4404 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5329
Mailing Address - Country:US
Mailing Address - Phone:504-455-5523
Mailing Address - Fax:504-455-6941
Practice Address - Street 1:817 W ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-6219
Practice Address - Country:US
Practice Address - Phone:504-712-3551
Practice Address - Fax:504-712-3556
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA724-185T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1171131Medicaid
LA1171131Medicaid
LAT69530Medicare UPIN