Individual
BENJAMIN G COCHRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4201 HENRY AVE, PHILADELPHIA, PA 19144-5409
(215) 951-2700
Mailing address
502 LAZY LN, ABSECON, NJ 08201-1337
(609) 432-0614
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YHB3HZN06874750
HORIZON BLUE CROSS BLUE SHIELD
NJ
Enumeration date
08/25/2020
Last updated
08/25/2020
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