Provider Demographics
NPI:1538221775
Name:COHEN, PAUL JAY (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JAY
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2508
Mailing Address - Country:US
Mailing Address - Phone:203-389-3935
Mailing Address - Fax:203-389-5532
Practice Address - Street 1:11 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2508
Practice Address - Country:US
Practice Address - Phone:203-389-3935
Practice Address - Fax:203-389-5532
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029755207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF05713Medicare UPIN