Bradley David Cohen, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

174127 Issued in NY

Practice address

15 Park Ave
Bay Shore, NY 11706-7381

Phone

(631) 581-4400

Fax

(631) 277-3750

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1104859925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARK AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067381",
            "telephone_number": "631-581-4400",
            "fax_number": "631-277-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARK AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067381",
            "telephone_number": "631-581-4400",
            "fax_number": "631-277-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "BRADLEY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "174127",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "174127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "174127",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01151486",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia J Selgrad DO PC
• Hilda Mariette Clesidor-Louis
• Kyle Cobb
• Melissa Deleana Coefield, LPN
• Maria Coffey, PA
• Daniel H Cohen, MD
• Lindsay Cohen, LCSW
• Zoe Colasacco, MD
• Ashley Michelle Cole, LPMHC
• Douglas Reese Cole, M.D.

• Surgery Physician in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.