Provider Demographics
NPI:1336406453
Name:MICHAEL J COHN O.D. PLLC
Entity Type:Organization
Organization Name:MICHAEL J COHN O.D. PLLC
Other - Org Name:MICHAEL J COHN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-832-9392
Mailing Address - Street 1:48 AUBURN STREET
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501
Mailing Address - Country:US
Mailing Address - Phone:508-832-9392
Mailing Address - Fax:508-832-2497
Practice Address - Street 1:48 AUBURN STREET
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501
Practice Address - Country:US
Practice Address - Phone:508-832-9392
Practice Address - Fax:508-832-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty