Provider Demographics
NPI:1457535783
Name:COHEN, RANDI LYNN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:LYNN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LLOYD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1151
Mailing Address - Country:US
Mailing Address - Phone:718-986-0353
Mailing Address - Fax:
Practice Address - Street 1:1698 POST RD E STE 2A
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5652
Practice Address - Country:US
Practice Address - Phone:203-450-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0466912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry