Basic Information
| Provider Information | |||||||||
| NPI: | 1083063101 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ELI COHEN MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6290 LINTON BLVD | ||||||||
| Address2: | STE 201 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334846409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614951337 | ||||||||
| FaxNumber: | 5614955892 | ||||||||
| Practice Location | |||||||||
| Address1: | 6290 LINTON BLVD | ||||||||
| Address2: | STE 201 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334846409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614951337 | ||||||||
| FaxNumber: | 5614955892 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2016 | ||||||||
| LastUpdateDate: | 06/09/2016 | ||||||||
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| AuthorizedOfficialLastName: | COHEN | ||||||||
| AuthorizedOfficialFirstName: | ELIAHOU | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5614951337 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.