Provider Demographics
NPI:1811346513
Name:COHEN, MARISA
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 WEST 83RD STREET
Mailing Address - Street 2:APT. 4F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5009
Mailing Address - Country:US
Mailing Address - Phone:845-216-1095
Mailing Address - Fax:
Practice Address - Street 1:112 WEST 34TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10120-0101
Practice Address - Country:US
Practice Address - Phone:212-502-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist