Individual
MR. DERRICK KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L, CO
Contact information
Practice address
142-60 56TH RD., FLUSHING, NY 11355
(646) 250-6429
Mailing address
142-60 56TH RD., FLUSHING, NY 11355
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
CO003271
NY
225X00000X
Occupational Therapist
Primary
017182
NY
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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