Individual
DR. MARC E. KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
450 MAMARONECK AVE STE 201, HARRISON, NY 10528-2436
(914) 637-3511
(914) 560-2227
Mailing address
450 MAMARONECK AVE STE 201, HARRISON, NY 10528-2436
(914) 637-3511
(914) 560-2227
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
192817
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD424232
PA
208VP0000X
Pain Medicine Physician
MD424233
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01654448
—
NY
05
—
1017403330001
—
PA
05
—
1043365299
—
VA
05
—
1548443153
—
VA
Enumeration date
11/02/2005
Last updated
06/01/2020
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