Provider Demographics
NPI:1750389458
Name:COHEN, RORY S (DPM)
Entity type:Individual
Prefix:
First Name:RORY
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2706
Mailing Address - Country:US
Mailing Address - Phone:718-797-3668
Mailing Address - Fax:718-802-7120
Practice Address - Street 1:420 FULTON ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5214
Practice Address - Country:US
Practice Address - Phone:718-797-3668
Practice Address - Fax:718-802-7120
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2009-12-10
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
NYN004877213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01259094Medicaid
NYU33850Medicare UPIN
NY01259094Medicaid