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Individual

CHRISTINE J KO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
15 YORK STREET, LMP 5031, NEW HAVEN, CT 06510
(203) 785-4094
(203) 785-6869
Mailing address
PO BOX 208059, YALE DERMATOPATHOLOGY LABORATORY, NEW HAVEN, CT 06520-8059
(203) 785-4094
(203) 785-6869

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD426011
PA
207ND0900X
Dermatopathology Physician
Primary
MD426011
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101266539
PA
Enumeration date
05/03/2006
Last updated
07/06/2012
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