1740462449 NPI number — IRIS COHN

Table of content: (NPI 1740462449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740462449 NPI number — IRIS COHN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IRIS COHN
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:
1740462449
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4370 KISSENA BLVD
Provider Second Line Business Mailing Address:
SUITE LH
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11355-3769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-353-8787
Provider Business Mailing Address Fax Number:
718-353-1367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4370 KISSENA BLVD
Provider Second Line Business Practice Location Address:
SUITE LH
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-3769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-353-8787
Provider Business Practice Location Address Fax Number:
718-353-1367
Provider Enumeration Date:
12/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COHN
Authorized Official First Name:
IRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PODIATRIST
Authorized Official Telephone Number:
718-353-8787

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  N003226 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: N003226 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00804348 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1C7167 . This is a "PHS" identifier . This identifiers is of the category "OTHER".
  • Identifier: PL1921 . This is a "BCMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: P37561 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10202523 . This is a "CAREPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 169790 . This is a "ELDERPLAN" identifier . This identifiers is of the category "OTHER".




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