Provider Demographics
NPI:1477691293
Name:KOCH, ROBERT K (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:KOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:316 EISENHOWER PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1718
Mailing Address - Country:US
Mailing Address - Phone:973-716-9600
Mailing Address - Fax:973-716-9650
Practice Address - Street 1:316 EISENHOWER PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1718
Practice Address - Country:US
Practice Address - Phone:973-716-9600
Practice Address - Fax:973-716-9650
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA55408207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF31075Medicare UPIN