Mario Cohen, MD

Individual provider Active NPI Obstetrics & Gynecology Physician · W Hartford, CT

NPI 1285741801 · NPPES record last updated Jan 31, 2013

Key facts

NPI
1285741801
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
028179 (CT)
Practice address
345 N Main St
Suite 201
W Hartford, CT 06117
Phone
(860) 561-7222
Fax
(860) 561-7228
NPI assigned
Aug 23, 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
028179CTMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 028179 CT Yes

Addresses

Primary practice location

345 N Main St
Suite 201
W Hartford, CT 06117

Mailing address

345 N Main St
Suite 201
W Hartford, CT 06117
Phone (860) 561-7222

Other identifiers

IdentifierTypeStateIssuer
001281790MedicaidCT

Other providers in W Hartford, CT

All providers in W Hartford, CT · Obstetrics & Gynecology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.