Organization
FREDERIC E COHEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERIC ETHAN COHEN (OWNER)
(718) 469-0014
Entity
Organization
Contact information
Practice address
2814 CLARENDON RD, BROOKLYN, NY 11226-6318
(718) 469-0014
Mailing address
607 HOWARD AVE, WEST HEMPSTEAD, NY 11552-3115
(516) 385-2146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
05-0085-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02319015
—
NY
Enumeration date
10/05/2011
Last updated
10/05/2011
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