Basic Information
Provider Information
NPI: 1376589952
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: DONNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 555 N DUKE ST
Address2:  
City: LANCASTER
State: PA
PostalCode: 176022250
CountryCode: US
TelephoneNumber: 7175445511
FaxNumber:  
Practice Location
Address1: 540 N DUKE ST
Address2: 3RD FLOOR
City: LANCASTER
State: PA
PostalCode: 176022374
CountryCode: US
TelephoneNumber: 7175444950
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2006
LastUpdateDate: 04/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD417571PAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
779934201PAAETNAOTHER
00177751901PAHIGHMARK BLUE SHIELDOTHER
245812300001PAINDEPENDENCEBLUE CROSSOTHER
101352889 000405PA MEDICAID
10492801PAGEISINGEROTHER
5008273201PACAPITAL BLUE CROSSOTHER
00000017065701PAUNISONOTHER
2004743201PAAMERIHEALTH MERCYOTHER
P0025604001PARAILROAD MEDICAREOTHER
P00677601PAGATEWAYOTHER


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