Provider Demographics
NPI:1447320296
Name:COHEN, MARTIN SAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:SAUL
Last Name:COHEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WOODLAND AVENUE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10535-3138
Mailing Address - Country:US
Mailing Address - Phone:914-834-1449
Mailing Address - Fax:212-865-0696
Practice Address - Street 1:7 WOODLAND AVENUE
Practice Address - Street 2:SUITE 9
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10535-3138
Practice Address - Country:US
Practice Address - Phone:914-834-1449
Practice Address - Fax:212-865-0696
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004649103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00502507Medicaid
NY00502507Medicaid
16901Medicare UPIN