Provider Demographics
NPI:1710929138
Name:KOCMAN, GEORGE J JR (MS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:J
Last Name:KOCMAN
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 MAURICE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1386
Mailing Address - Country:US
Mailing Address - Phone:717-801-1600
Mailing Address - Fax:717-801-1600
Practice Address - Street 1:626 MAURICE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-1386
Practice Address - Country:US
Practice Address - Phone:717-801-1600
Practice Address - Fax:717-801-1600
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007141L103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA463293OtherVALUE OPTIONS
PA03265301OtherCAPITAL BLUE CROSS
PA2107727OtherMAMSI
PA098755000OtherMAGELLAN
PA604755OtherPA BLUE SHIELD
PA2164053OtherCIGNA BEHAVIORAL HEALTH
PA60606301OtherBC/BS OF MD CARE FIRST
PAR88242Medicare UPIN