Provider Demographics
NPI:1235124355
Name:COHEN, STEVEN R (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E 86TH ST
Mailing Address - Street 2:APT 10H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7533
Mailing Address - Country:US
Mailing Address - Phone:212-628-9013
Mailing Address - Fax:
Practice Address - Street 1:1305 YORK AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5663
Practice Address - Country:US
Practice Address - Phone:646-962-3376
Practice Address - Fax:646-962-0033
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157918207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01089481Medicaid
NY354241Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NY01089481Medicaid