Most Relevant Information
Provider Data
| NPI Number: | 1003470626 |
| Provider Name: | ELISE COHEN |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/29/2019 |
| Last Updated: | 06/11/2019 |
Provider Practice Location
859 WILLARD ST
QUINCY
MA
021697482
Practice Location Phone/Fax
| Phone: | 7036150212 |
| Fax: |
Provider Mailing Location
21050 41ST AVE APT 5C
BAYSIDE
NY
113611916
Provider Mailing Phone/Fax
| Phone: | 7036150212 |
| Fax: |