Individual
GARY COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 COTTAGE GROVE RD, SUITE 107, BLOOMFIELD, CT 06002-3088
(860) 243-8709
(860) 243-8259
Mailing address
580 COTTAGE GROVE RD, SUITE 107, BLOOMFIELD, CT 06002-3088
(860) 243-8709
(860) 243-8259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
018911
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001189117
—
CT
01
—
010018911CT01
ANTHME BLUE SHIELD
CT
01
—
0V3692
HEALTHNET
—
Enumeration date
07/26/2006
Last updated
06/22/2021
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