Provider Demographics
NPI:1700918414
Name:COHEN-ADDAD, NICOLE ESTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ESTHER
Last Name:COHEN-ADDAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6039 BOARDWALK DR
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3207
Mailing Address - Country:US
Mailing Address - Phone:607-331-6183
Mailing Address - Fax:
Practice Address - Street 1:6039 BOARDWALK DR
Practice Address - Street 2:
Practice Address - City:TOBYHANNA
Practice Address - State:PA
Practice Address - Zip Code:18466-3207
Practice Address - Country:US
Practice Address - Phone:607-331-6183
Practice Address - Fax:
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
PAMD4242232080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine