Basic Information
Provider Information
NPI: 1235564576
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: ALLISON
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11 EAGLE ROCK AVE
Address2:  
City: EAST HANOVER
State: NJ
PostalCode: 07936
CountryCode: US
TelephoneNumber: 9738879000
FaxNumber: 9738873816
Practice Location
Address1: 6612-18 BERGENLINE AVE.
Address2:  
City: WEST NEW YORK
State: NJ
PostalCode: 07093
CountryCode: US
TelephoneNumber: 2018545511
FaxNumber: 2018545522
Other Information
ProviderEnumerationDate: 09/05/2013
LastUpdateDate: 02/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X46TR00625300NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225X00000X018110-1NYN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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