Provider Demographics
NPI:1740440981
Name:COHEN, EDWIN PETER (PHD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:PETER
Last Name:COHEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-6904
Mailing Address - Country:US
Mailing Address - Phone:609-924-2225
Mailing Address - Fax:
Practice Address - Street 1:43 SPRING ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-6904
Practice Address - Country:US
Practice Address - Phone:609-924-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 02653103T00000X
NY00088891103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist