Basic Information
Provider Information
NPI: 1568420420
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: JENNIFER
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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OtherMiddleName:  
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Mailing Information
Address1: 100 E PENN SQ
Address2: 9TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191073323
CountryCode: US
TelephoneNumber: 2674259234
FaxNumber: 2674259299
Practice Location
Address1: 3401 CIVIC CENTER BLVD
Address2: CHILDREN'S HOSPITAL OF PHILADELPHIA - NEONATOLOGY
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155901944
FaxNumber: 2155904454
Other Information
ProviderEnumerationDate: 05/02/2006
LastUpdateDate: 04/17/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080N0001XMD444309PAY Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine

No ID Information.


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