Individual provider Active NPI

Sidney J Cohen, PH.D.

  • Clinical Psychologist
  • Cherry Hill, NJ
National Provider Identifier
1790863272
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
S1573 Issued in NJ
Practice address
1500 Kings Hwy N Ste 208
Cherry Hill, NJ 08034-2304
Phone
(856) 428-1685
Fax
(856) 428-9059
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X S1573 NJ Primary

Addresses

Primary practice location

1500 Kings Hwy N Ste 208
Cherry Hill, NJ 08034-2304

Mailing address

1500 Kings Hwy N Ste 208
Cherry Hill, NJ 08034-2304
Phone (856) 428-1685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050526000391 NJ Practitioner - Clinical Psychologist 9133161417 Practice locations: Cherry Hill, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1500 Kings Hwy N
Suite 208
Cherry Hill, NJ 08034-2304
Phone (856) 428-1685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
S1573NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790863272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 KINGS HWY N STE 208",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342304",
            "telephone_number": "856-428-1685",
            "fax_number": "856-428-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 KINGS HWY N STE 208",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342304",
            "telephone_number": "856-428-1685",
            "fax_number": "856-428-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "SIDNEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "S1573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.