Individual
DR. KOJI TAKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
177 FORT WASHINGTON AVE, MHB 7GN-435, NEW YORK, NY 10032-3733
(212) 342-3892
(212) 342-5262
Mailing address
PO BOX 27765, NEW YORK, NY 10087-7765
(212) 305-9576
(212) 305-9480
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
267435
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03529031
—
NY
Enumeration date
02/17/2012
Last updated
02/04/2019
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