Provider Demographics
NPI:1083884753
Name:KOCH, WILLIAM HARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARRISON
Last Name:KOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MILBANK AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6616
Mailing Address - Country:US
Mailing Address - Phone:203-622-0337
Mailing Address - Fax:203-622-1726
Practice Address - Street 1:151 MILBANK AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6616
Practice Address - Country:US
Practice Address - Phone:203-622-0337
Practice Address - Fax:203-622-1726
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-09
Last Update Date:2008-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0252212084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry