Provider Demographics
NPI:1497215271
Name:COHAN, HOLLY STRADECKI (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:STRADECKI
Last Name:COHAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:STRADECKI-COHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:1205 PARK AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:844-692-4692
Practice Address - Fax:212-562-6234
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3227552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY322755OtherNEW YORK STATE MEDICAL LICENSE