Provider Demographics
NPI:1609882489
Name:COHEN, DONALD S (OD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 STRATHMORE AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1119
Mailing Address - Country:US
Mailing Address - Phone:301-946-7307
Mailing Address - Fax:
Practice Address - Street 1:8957 EDMONSTON RD
Practice Address - Street 2:SUITE E & G
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1005
Practice Address - Country:US
Practice Address - Phone:301-474-7712
Practice Address - Fax:301-220-0080
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0536152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT-30933Medicare UPIN
MDCO-146684Medicare ID - Type Unspecified