Provider Demographics
NPI:1326081167
Name:KOCHEN, ILANA (MD)
Entity Type:Individual
Prefix:
First Name:ILANA
Middle Name:
Last Name:KOCHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 E 89TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1251
Mailing Address - Country:US
Mailing Address - Phone:212-369-5969
Mailing Address - Fax:
Practice Address - Street 1:45 E 89TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1251
Practice Address - Country:US
Practice Address - Phone:212-369-5969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128971174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00238064Medicaid
NY00238064Medicaid
NYB13405Medicare UPIN