Provider Demographics
NPI:1780808469
Name:COHEN, JOAN DORFMAN (PHD, APRN,)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:DORFMAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD, APRN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NORTHERN BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4809
Mailing Address - Country:US
Mailing Address - Phone:516-482-3312
Mailing Address - Fax:516-482-3586
Practice Address - Street 1:350 NORTHERN BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4809
Practice Address - Country:US
Practice Address - Phone:516-482-3312
Practice Address - Fax:516-482-3586
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174701 1364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health