Provider Demographics
NPI:1053572545
Name:COHEN, NANCY O (DMD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:O
Last Name:COHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-6002
Mailing Address - Country:US
Mailing Address - Phone:914-779-6789
Mailing Address - Fax:914-779-5069
Practice Address - Street 1:1579 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-6002
Practice Address - Country:US
Practice Address - Phone:914-779-6789
Practice Address - Fax:914-779-5069
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039913-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice