Provider Demographics
NPI:1730403932
Name:COHEN, MARSHALL ALLEN (BS)
Entity type:Individual
Prefix:MR
First Name:MARSHALL
Middle Name:ALLEN
Last Name:COHEN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KINGS MILL RD
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-8902
Mailing Address - Country:US
Mailing Address - Phone:609-235-9390
Mailing Address - Fax:
Practice Address - Street 1:2758 GERRITSEN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5915
Practice Address - Country:US
Practice Address - Phone:718-332-7155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist