Cohen, Ezra M.

Cohen, Ezra M. is an individual health care provider with primary practice located at 850 Harrison Avenue, Yacc 6 Pediatric Primary Care & Adolescent Clinic, Boston MA 02118. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Rheumatology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Cohen, Ezra M. can be contacted via phone (617) 414-5946.

Contact Information

Primary practice address
850 Harrison Avenue, Yacc 6 Pediatric Primary Care & Adolescent Clinic Boston MA 02118
Phone: (617) 414-5946
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Rheumatology 2080P0216X 258382 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 258382 Massachusetts

Profile Details

NPI number 1144515818
LBN Legal business name Cohen, Ezra M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2011
Last updated Oct 5th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144515818 NPPES
Massachusetts MEDICAID 110100633A

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