Basic Information
Provider Information
NPI: 1124160320
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: HILLEL
MiddleName: DAVID
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 740177
Address2:  
City: BOYNTON BEACH
State: FL
PostalCode: 334740177
CountryCode: US
TelephoneNumber: 5617402900
FaxNumber: 5614340598
Practice Location
Address1: 7200 W CAMINO REAL
Address2: SUITE 300
City: BOCA RATON
State: FL
PostalCode: 334335511
CountryCode: US
TelephoneNumber: 5614874110
FaxNumber: 5614872939
Other Information
ProviderEnumerationDate: 02/13/2007
LastUpdateDate: 01/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X25MA07693500NJN Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RG0100XME104518FLY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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