Active NPI
Gary Mark Cohen, M.D.
- Gastroenterology Physician
- Meriden, CT
National Provider Identifier
1093738197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 014594
- Practice address
- 455 Lewis Ave
Suite 106
Meriden, CT 06451-2121 - Phone
- (203) 886-0036
- Fax
- (203) 886-0072
- NPI assigned
- Jul 26, 2006
- Last updated
- Aug 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 014594 | CT | |
| Gastroenterology Physician | 207RG0100X | 014594 | CT | Primary |
Addresses
Primary practice location
455 Lewis Ave
Suite 106
Meriden, CT 06451-2121
Mailing address
2139 Silas Deane Hwy
Rocky Hill, CT 06067-2336
Phone (860) 257-4131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1145945 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313712000000",
"number": "1093738197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2139 SILAS DEANE HWY",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "060672336",
"telephone_number": "860-257-4131",
"fax_number": "860-257-4519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 LEWIS AVE",
"address_2": "SUITE 106",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064512121",
"telephone_number": "203-886-0036",
"fax_number": "203-886-0072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "GARY",
"middle_name": "MARK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2011-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "014594",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CT",
"license": "014594",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1145945",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meriden, CT
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.