Individual
GARY S COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140
(215) 707-7237
(215) 707-9389
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7237
(215) 707-9389
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD042660L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012942540001
—
PA
Enumeration date
10/17/2005
Last updated
07/23/2018
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