Provider Demographics
NPI:1053399600
Name:COHEN, ALAN B (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:B
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3003 NEW HYDE PARK RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1214
Mailing Address - Country:US
Mailing Address - Phone:516-327-0001
Mailing Address - Fax:516-326-9753
Practice Address - Street 1:3003 NEW HYDE PARK RD
Practice Address - Street 2:SUITE 411
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1214
Practice Address - Country:US
Practice Address - Phone:516-327-0001
Practice Address - Fax:516-326-9753
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY169603207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01155733Medicaid
NYD92121Medicare UPIN
NY01155733Medicaid