Provider Demographics
NPI:1811137953
Name:IRIS COHN
Entity type:Organization
Organization Name:IRIS COHN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
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:2009-03-03
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP37561OtherEMPIRE BLUE CROSS BLUE SHIELD
NY00804348Medicaid
NYP37561OtherEMPIRE BLUE CROSS BLUE SHIELD
NY4304940001Medicare NSC