Individual
DR. JEFFERY R COEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
294 WASHINGTON ST, SUITE 217, BOSTON, MA 02108-4634
(617) 426-8464
Mailing address
19 DEHON ST, REVERE, MA 02151-3220
(781) 284-5954
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1645
MA
213E00000X
Podiatrist
Primary
PD 1645
MA
213ES0131X
Foot Surgery Podiatrist
1645
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0344907
—
MA
01
—
339554
BC/BS DME
MA
01
—
Y70711
MEDICARE
MA
Enumeration date
04/26/2006
Last updated
08/02/2021
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