Individual
ELSIE KOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1225 MCBRIDE AVE, SUITE 116, WOODLAND PARK, NJ 07424-3812
(973) 837-1018
(973) 837-1329
Mailing address
40 VALLEY STREAM PKWY STE 100, ATTN: CREDENTIALING DEPT., MALVERN, PA 19355-1407
(610) 644-8900
(610) 644-8909
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA07546000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071850
MEDICARE - NJ
NJ
05
—
9122401
—
NJ
Enumeration date
02/17/2006
Last updated
10/21/2016
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