Individual
EZRA M. COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 HARRISON AVENUE, YACC 6, PEDIATRIC PRIMARY CARE & ADOLESCENT CLINIC, BOSTON, MA 02118
(617) 414-5946
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
258382
MA
2080P0216X
Pediatric Rheumatology Physician
258382
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110100633A
—
MA
Enumeration date
06/10/2011
Last updated
10/05/2017
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