Organization
GLENN R KOCH AND ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN ROBERT KOCH MA (PRESIDENT LICENSED PSYCHOLOGIST)
(610) 266-0610
Entity
Organization
Contact information
Practice address
961 MARCON BOULEVARD, SUITE 312, ALLENTOWN, PA 18109
(610) 266-0610
(610) 266-0292
Mailing address
961 MARCON BOULEVARD, SUITE 312, ALLENTOWN, PA 18109
(610) 266-0610
(610) 266-0292
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
PS005286L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016509210002
—
PA
01
—
02817200
CAPITAL BLUE CROSS
PA
01
—
GL1454227
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/18/2006
Last updated
08/22/2020
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