Provider Demographics
NPI:1952528598
Name:COHEN, LAWRENCE STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:STEVEN
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2041 BANCROFT WAY
Mailing Address - Street 2:SUITE 307-310
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1405
Mailing Address - Country:US
Mailing Address - Phone:510-981-9141
Mailing Address - Fax:510-649-1133
Practice Address - Street 1:2041 BANCROFT WAY
Practice Address - Street 2:SUITE 307-310
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1405
Practice Address - Country:US
Practice Address - Phone:510-981-9141
Practice Address - Fax:510-649-1133
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA427492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF08493Medicare UPIN