Basic Information
| Provider Information | |||||||||
| NPI: | 1306888144 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COHEN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | JOEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 W 62ND ST APT 22A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100237532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175190310 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 PORT WASHINGTON BLVD STE 105 | ||||||||
| Address2: | |||||||||
| City: | ROSLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115761353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163909640 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 03/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 2006023527 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RI0011X | 305164 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | KA1021046 | 01 | KS | MEDICARE - CUSHING | OTHER | 200388360E | 05 | KS | MEDICAID | 204023501 | 05 | MO | MEDICAID | P00842659 | 01 | MO | RAILROAD MEDICARE | OTHER | 200388360C | 01 | KS | MEDICAID - CUSHING | OTHER | 200388360B | 05 | KS | MEDICAID | 200388360F | 05 | KS | MEDICAID | P00832501 | 01 | KS | RAILROAD MEDICARE | OTHER |