Eric Cohen, OD
Individual provider Active NPI Optometrist · Balto, MD
NPI 1619993607 · NPPES record last updated Apr 25, 2011
Key facts
- NPI
- 1619993607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 662 (MD)
- Practice address
- 6660 Security Blvd
Balto, MD 21207 - Phone
- (410) 944-8020
- Fax
- (410) 944-5621
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 662 | MD | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 662 | MD | Yes |
Addresses
Primary practice location
6660 Security Blvd
Balto, MD 21207
Mailing address
6660 Security Blvd
Baltimore, MD 21207
Phone (410) 944-8020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 801958401 | Medicaid | MD |
Other providers in Balto, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.