Provider Demographics
NPI:1700915196
Name:COHEN, MIRIAM (DPT)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 FLORAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1542
Mailing Address - Country:US
Mailing Address - Phone:908-731-5821
Mailing Address - Fax:908-333-4743
Practice Address - Street 1:98 FLORAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1542
Practice Address - Country:US
Practice Address - Phone:908-333-4743
Practice Address - Fax:908-333-4743
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA010780002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics