Provider Demographics
NPI:1205060795
Name:COHEN, TAMMY ELLEN (RN,DNP, NP, PMHNP)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:ELLEN
Last Name:COHEN
Suffix:
Gender:F
Credentials:RN,DNP, NP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 GOLD ST APT 402
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1646
Mailing Address - Country:US
Mailing Address - Phone:917-903-5133
Mailing Address - Fax:
Practice Address - Street 1:184 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519
Practice Address - Country:US
Practice Address - Phone:203-688-1936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400702-1363LP0808X
CT8418363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health