Provider Demographics
NPI:1457904930
Name:COHEN, JEANNETT MARTINEZ
Entity Type:Individual
Prefix:MRS
First Name:JEANNETT
Middle Name:MARTINEZ
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 1:67 EVERS LN APT SUITE
Mailing Address - Street 2:
Mailing Address - City:HIGH FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12440-5821
Mailing Address - Country:US
Mailing Address - Phone:845-596-4382
Mailing Address - Fax:
Practice Address - Street 1:67 EVERS LN APT SUITE
Practice Address - Street 2:
Practice Address - City:HIGH FALLS
Practice Address - State:NY
Practice Address - Zip Code:12440-5821
Practice Address - Country:US
Practice Address - Phone:845-596-4382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist