Provider Demographics
NPI:1043259260
Name:COHEN, RALPH L (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:L
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:664 MAIN ST
Mailing Address - Street 2:STE 54
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2439
Mailing Address - Country:US
Mailing Address - Phone:413-253-9542
Mailing Address - Fax:413-549-5926
Practice Address - Street 1:664 MAIN ST
Practice Address - Street 2:STE 54
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2439
Practice Address - Country:US
Practice Address - Phone:413-253-9542
Practice Address - Fax:413-549-5926
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA430242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2069342Medicaid
MA2069342Medicaid