Cohen, Ezra M.
Cohen, Ezra M. is an individual health care provider with primary practice located at 850 Harrison Avenue, Yacc 6 Pediatric Primary Care & Adolescent Clinic, Boston MA 02118. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Rheumatology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Cohen, Ezra M. can be contacted via phone (617) 414-5946.Contact Information
Primary practice address
850 Harrison Avenue, Yacc 6 Pediatric Primary Care & Adolescent Clinic
Boston MA 02118
Phone: (617) 414-5946
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Rheumatology | 2080P0216X | 258382 | Massachusetts |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 258382 | Massachusetts |
Profile Details
NPI number | 1144515818 |
---|---|
LBN Legal business name | Cohen, Ezra M. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 10th, 2011 |
Last updated | Oct 5th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1144515818 | NPPES |
Massachusetts | MEDICAID | 110100633A |
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