Provider Demographics
NPI:1174132443
Name:COHEN FASHION OPTICAL, LLC
Entity type:Organization
Organization Name:COHEN FASHION OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-413-4186
Mailing Address - Street 1:1318 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5492
Mailing Address - Country:US
Mailing Address - Phone:215-545-3937
Mailing Address - Fax:215-545-3938
Practice Address - Street 1:1318 WALNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5492
Practice Address - Country:US
Practice Address - Phone:215-545-3937
Practice Address - Fax:215-545-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier