Individual provider Active NPI

Ian Jordan Cohen

  • Psychologist
  • Forest Hills, NY
National Provider Identifier
1992119093
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018091 Issued in NY
Practice address
10848 70TH Rd
Apt 7E
Forest Hills, NY 11375-3937
Phone
(215) 990-2141
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018091 NY Primary

Addresses

Primary practice location

10848 70TH Rd
Apt 7E
Forest Hills, NY 11375-3937

Mailing address

10848 70TH Rd
Apt 7E
Forest Hills, NY 11375-3937
Phone (215) 990-2141

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
018091NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1992119093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10848 70TH RD",
            "address_2": "APT 7E",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753937",
            "telephone_number": "215-990-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10848 70TH RD",
            "address_2": "APT 7E",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753937",
            "telephone_number": "215-990-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "IAN",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.