Individual
CASEY COHOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-8510
Mailing address
923 48TH ST, BROOKLYN, NY 11219-2919
(718) 283-8510
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9116862
FL
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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