Provider Demographics
NPI:1710128400
Name:KOELSCH, EMILY MIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MIKA
Last Name:KOELSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2670
Mailing Address - Country:US
Mailing Address - Phone:914-332-4141
Mailing Address - Fax:914-332-0750
Practice Address - Street 1:150 WHITE PLAINS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-2670
Practice Address - Country:US
Practice Address - Phone:914-332-4141
Practice Address - Fax:914-332-0750
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248764208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics