Provider Demographics
NPI:1700966330
Name:COHEN, HERMAN P (DO)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:P
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5647 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08110-1836
Mailing Address - Country:US
Mailing Address - Phone:856-663-1470
Mailing Address - Fax:856-663-3409
Practice Address - Street 1:5647 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08110-1836
Practice Address - Country:US
Practice Address - Phone:856-663-1470
Practice Address - Fax:856-663-3409
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ61259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2067696OtherOXFORD
0964523000OtherKEYSTONE
NJ0268790001OtherAMERIHEALTH
NJ3370OtherAETNA
NJ01000217900OtherAMERICHOICE
NJ6897207Medicaid
NJ1114380OtherHORIZON NJ HEALTH
NJ223695964OtherHORIZON BLUE CROSS NJ
NJ0268790001OtherAMERIHEALTH
NJ1114380OtherHORIZON NJ HEALTH