Provider Demographics
NPI:1750399556
Name:COHEN, JOEL STUART (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:STUART
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 WILLIAMSBRIDGE ROAD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-597-8000
Mailing Address - Fax:718-597-8002
Practice Address - Street 1:1610 WILLIAMSBRIDGE ROAD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-597-8000
Practice Address - Fax:718-597-8002
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1596572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01061912Medicaid
569N0OtherEMPIRE BLUE CROSS BLUE SH
P2874157OtherOXFORD
13E051Medicare ID - Type Unspecified
A60649Medicare UPIN