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Individual

GARY MARK COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
455 LEWIS AVE, SUITE 106, MERIDEN, CT 06451-2121
(203) 886-0036
(203) 886-0072
Mailing address
2139 SILAS DEANE HWY, ROCKY HILL, CT 06067-2336
(860) 257-4131
(860) 257-4519

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
014594
CT
207RG0100X
Gastroenterology Physician
Primary
014594
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1145945
CT
Enumeration date
07/26/2006
Last updated
08/19/2011
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