Individual
BRIAN KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BAY ST, GLEN RIDGE, NJ 07028-1505
(925) 595-1994
Mailing address
306 HUDSON ST APT 1, HOBOKEN, NJ 07030-5849
(925) 595-1994
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA10240700
NJ
207P00000X
Emergency Medicine Physician
A149062
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2015
Last updated
09/20/2022
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