1477522910 NPI number — COHEN DERMATOPATHOLOGY, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477522910 NPI number — COHEN DERMATOPATHOLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COHEN DERMATOPATHOLOGY, P.C.
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:
6
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:
1477522910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6655 N MACARTHUR BLVD
Provider Second Line Business Mailing Address:
ATTN: PROVIDER ENROLLMENT
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75039-2443
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-596-7031
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 CRAWFORD STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NEEDHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-969-4100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIMONDS
Authorized Official First Name:
DANA
Authorized Official Middle Name:
ARLENE
Authorized Official Title or Position:
SVP, COMPLIANCE, ETHICS & QUALITY
Authorized Official Telephone Number:
214-277-8700

Provider Taxonomy Codes

  • Taxonomy code: 207ND0900X , with the licence number:  2663 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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