Provider Demographics
NPI:1184781072
Name:IVAN COHEN MD AND ASSOCIATES LLC
Entity type:Organization
Organization Name:IVAN COHEN MD AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-292-0888
Mailing Address - Street 1:262 CHAPMAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5448
Mailing Address - Country:US
Mailing Address - Phone:302-292-0888
Mailing Address - Fax:302-292-0889
Practice Address - Street 1:262 CHAPMAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5448
Practice Address - Country:US
Practice Address - Phone:302-292-0888
Practice Address - Fax:302-292-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100042872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty