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Individual

DR. BRADLEY DAVID COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15 PARK AVE, BAY SHORE, NY 11706-7381
(631) 581-4400
(631) 277-3750
Mailing address
15 PARK AVE, BAY SHORE, NY 11706-7381
(631) 581-4400
(631) 277-3750

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
174127
NY
2086X0206X
Surgical Oncology Physician
174127
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01151486
NY
01
174127
LICENSE
NY
Enumeration date
07/07/2006
Last updated
04/12/2021
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