Provider Demographics
NPI:1912940883
Name:COHEN, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HORIZON DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3966
Mailing Address - Country:US
Mailing Address - Phone:215-997-3668
Mailing Address - Fax:215-997-0992
Practice Address - Street 1:1500 HORIZON DR
Practice Address - Street 2:SUITE 106
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3966
Practice Address - Country:US
Practice Address - Phone:215-997-3668
Practice Address - Fax:215-997-0992
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-004779-R213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
480032452OtherRAILROAD MEDICARE
PA048544Medicare PIN
480032452OtherRAILROAD MEDICARE
U67732Medicare UPIN