Provider Demographics
NPI:1669555629
Name:COHEN, BARRY HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:HOWARD
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 NORTHERN BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5100
Mailing Address - Country:US
Mailing Address - Phone:516-482-0600
Mailing Address - Fax:516-829-9674
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5100
Practice Address - Country:US
Practice Address - Phone:516-482-0600
Practice Address - Fax:516-829-9674
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116771207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08416Medicare UPIN
NY320221Medicare ID - Type Unspecified