Provider Demographics
NPI:1366404238
Name:COHEN, KENNETH R (MD,FACS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
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Mailing Address - Street 1:27 UNION SQ W
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3305
Mailing Address - Country:US
Mailing Address - Phone:212-505-2151
Mailing Address - Fax:212-645-3165
Practice Address - Street 1:303 2ND AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2739
Practice Address - Country:US
Practice Address - Phone:212-505-2151
Practice Address - Fax:212-505-7271
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2011-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY109168207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY061616047OtherTIN
NYB77904Medicare UPIN
NY571861Medicare ID - Type Unspecified