1083616767 NPI number — DR. LOUISE GLASSNER COHEN PHARM.D., BCPP

Table of content: DR. LOUISE GLASSNER COHEN PHARM.D., BCPP (NPI 1083616767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083616767 NPI number — DR. LOUISE GLASSNER COHEN PHARM.D., BCPP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COHEN
Provider First Name:
LOUISE
Provider Middle Name:
GLASSNER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D., BCPP
Provider Gender Code:
F

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:
1083616767
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33 MARTHAS LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTNUT HILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02467-2673
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-731-1346
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1493 CAMBRIDGE ST
Provider Second Line Business Practice Location Address:
CAMBRIDGE HEALTH ALLIANCE-MYSTIC CENTER
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02139-1047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-306-8639
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1300X , with the licence number:  18125 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com