Provider Demographics
NPI:1669436440
Name:COHEN, MARC S (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2301 E EVESHAM RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4501
Mailing Address - Country:US
Mailing Address - Phone:856-772-2552
Mailing Address - Fax:856-772-1946
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 101
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-772-2552
Practice Address - Fax:856-772-1946
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04990800207W00000X
PAMD034647E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0438567000OtherINDEPENDENCE BC/BS
PA112307OtherAETNA
NJ24047OtherAETNA
NJ7916205Medicaid
NH0085078000OtherINDEPENDENCE BC/BS
PA1237436Medicaid
NJF10363OtherHEALTHNET
PA112307OtherAETNA
NJ7916205Medicaid
PA610518Medicare ID - Type Unspecified