Provider Demographics
NPI:1205059466
Name:COHEN, ERIC M (PT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:M
Last Name:COHEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4367 NORTHVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716
Mailing Address - Country:US
Mailing Address - Phone:301-464-4500
Mailing Address - Fax:301-464-8818
Practice Address - Street 1:4367 NORTHVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716
Practice Address - Country:US
Practice Address - Phone:301-464-4500
Practice Address - Fax:301-464-8818
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist