1194872598 NPI number — DANIEL S COHEN MD PC

Table of content: (NPI 1194872598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194872598 NPI number — DANIEL S COHEN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL S COHEN MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194872598
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5425 N ORACLE RD STE 115
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85704-3890
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-742-9166
Provider Business Mailing Address Fax Number:
520-742-9146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5425 N ORACLE RD STE 115
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85704-3890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-742-9166
Provider Business Practice Location Address Fax Number:
520-742-9146
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COHEN
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
520-742-9166

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  23382 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 23382 . This is a "LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com