Provider Demographics
NPI:1700917648
Name:COHEN, STANLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:E NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-6215
Mailing Address - Country:US
Mailing Address - Phone:631-499-0066
Mailing Address - Fax:631-499-2650
Practice Address - Street 1:3027 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:E NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-6215
Practice Address - Country:US
Practice Address - Phone:631-499-0066
Practice Address - Fax:631-499-2650
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT002715-1152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision