Provider Demographics
NPI:1598723819
Name:KOCH, HELENE M (DO)
Entity Type:Individual
Prefix:DR
First Name:HELENE
Middle Name:M
Last Name:KOCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:25 BALA AVENUE
Mailing Address - Street 2:STE 205
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004
Mailing Address - Country:US
Mailing Address - Phone:610-667-6363
Mailing Address - Fax:610-667-5155
Practice Address - Street 1:25 BALA AVENUE
Practice Address - Street 2:STE 205
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004
Practice Address - Country:US
Practice Address - Phone:610-667-6363
Practice Address - Fax:610-667-5155
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007489L207V00000X
PAOS-007489-L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G26627Medicare UPIN
PA817162Medicare PIN