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Individual

REGINA MARIE KOCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
75 FRANCIS ST, RADIOLOGY DEPT, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
55 LAKE AVE N, RADIOLOGY DEPT, WORCESTER, MA 01655-0002
(508) 368-0000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
246556
MA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
246556
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
246556
1649430208
MA
01
R70177
TRAINING PERMIT
AZ
Enumeration date
06/16/2008
Last updated
02/13/2017
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