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Individual

MR. RICHARD KOOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
254 CANAL ST, RM 3005, NEW YORK, NY 10013-3501
(212) 941-8273
Mailing address
3998 FAIR RIDGE DRIVE, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
357479-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01259953
RAILROAD MEDICARE
NY
Enumeration date
05/20/2006
Last updated
04/03/2015
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