Basic Information
| Provider Information | |||||||||
| NPI: | 1447296736 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COHEN | ||||||||
| FirstName: | NADINE | ||||||||
| MiddleName: | JODI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 178 E 85TH ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100282119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124346776 | ||||||||
| FaxNumber: | 2124346781 | ||||||||
| Practice Location | |||||||||
| Address1: | 178 E 85TH ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100282119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124346776 | ||||||||
| FaxNumber: | 2124346781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 08/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA07871100 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 25MA0787110 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 237679 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 237679 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 100422 | 01 | NY | MEDICARE ID | OTHER |