Provider Demographics
NPI:1336365626
Name:COHEN, VERA DAWN
Entity Type:Individual
Prefix:MRS
First Name:VERA
Middle Name:DAWN
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:VERA
Other - Middle Name:DAWN
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 KING CHARLES LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2310
Mailing Address - Country:US
Mailing Address - Phone:215-504-8362
Mailing Address - Fax:
Practice Address - Street 1:33 KING CHARLES LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2310
Practice Address - Country:US
Practice Address - Phone:215-504-8362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001181L171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor