Provider Demographics
NPI:1750714903
Name:COHEN, SHA (RN, PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:SHA
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:RN, PARAMEDIC
Other - Prefix:MR
Other - First Name:SHACHAR
Other - Middle Name:
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2332 S LEYDEN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6236
Mailing Address - Country:US
Mailing Address - Phone:970-310-0102
Mailing Address - Fax:
Practice Address - Street 1:2332 S LEYDEN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6236
Practice Address - Country:US
Practice Address - Phone:970-310-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0201146163WC0200X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine