Provider Demographics
NPI:1043266216
Name:COHN, MONIQUE S (DO)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:S
Last Name:COHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932930
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-2930
Mailing Address - Country:US
Mailing Address - Phone:866-410-2026
Mailing Address - Fax:330-963-7900
Practice Address - Street 1:8940 DARROW RD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2110
Practice Address - Country:US
Practice Address - Phone:330-425-7600
Practice Address - Fax:330-963-7900
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005164207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0908085Medicaid
000000137680OtherANTHEM
CO0732703Medicare ID - Type Unspecified
000000137680OtherANTHEM