Provider Demographics
NPI:1700953049
Name:COHEN, STEVEN DAVID (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DAVID
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WHITEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670
Mailing Address - Country:US
Mailing Address - Phone:212-321-1922
Mailing Address - Fax:212-938-0157
Practice Address - Street 1:375 SOUTH END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10280
Practice Address - Country:US
Practice Address - Phone:212-321-1922
Practice Address - Fax:212-938-0157
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3784111N00000X
FL4667111N00000X
NJ2639111N00000X
CT522111N00000X
NH7531205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0X25191Medicare ID - Type Unspecified