Provider Demographics
NPI:1740462449
Name:IRIS COHN
Entity type:Organization
Organization Name:IRIS COHN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COHN
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:718-353-8787
Mailing Address - Street 1:4370 KISSENA BLVD
Mailing Address - Street 2:SUITE LH
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3769
Mailing Address - Country:US
Mailing Address - Phone:718-353-8787
Mailing Address - Fax:718-353-1367
Practice Address - Street 1:4370 KISSENA BLVD
Practice Address - Street 2:SUITE LH
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3769
Practice Address - Country:US
Practice Address - Phone:718-353-8787
Practice Address - Fax:718-353-1367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003226213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
N003226OtherHIP
NY00804348Medicaid
1C7167OtherPHS
PL1921OtherBCMC
P37561OtherBCBS
10202523OtherCAREPLUS
169790OtherELDERPLAN
N003226OtherHIP
169790OtherELDERPLAN