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Individual

IRA L COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1050 FOREST HILL RD, STATEN ISLAND, NY 10314-6356
(718) 494-5181
Mailing address
1050 FOREST HILL RD, STATEN ISLAND, NY 10314-6356
(718) 494-5181

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
005918-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01506409
NY
Enumeration date
09/12/2006
Last updated
05/02/2008
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