Provider Demographics
NPI:1245538008
Name:COHEN, CARYN DERI
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:DERI
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 W SAMPLE RD
Mailing Address - Street 2:#2301
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3024
Mailing Address - Country:US
Mailing Address - Phone:954-975-5760
Mailing Address - Fax:
Practice Address - Street 1:2900 W SAMPLE RD
Practice Address - Street 2:#2301
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33073-3024
Practice Address - Country:US
Practice Address - Phone:954-975-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other