Stephen U Cohen, MD

Individual provider Active NPI Pediatrics Physician · Belen, NM

NPI 1023024775 · NPPES record last updated Oct 24, 2011

Key facts

NPI
1023024775
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
74138 (NM)
Practice address
609 Christopher Dr
PMG Belen
Belen, NM 87002-2615
Phone
(505) 864-5454
Fax
(505) 864-5450
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74138NMMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 74138 NM Yes

Addresses

Primary practice location

609 Christopher Dr
PMG Belen
Belen, NM 87002-2615

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers

IdentifierTypeStateIssuer
1396MedicaidNM

Other providers in Belen, NM

All providers in Belen, NM · Pediatrics Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.