Provider Demographics
NPI:1942216320
Name:KO, PAULA (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:KO
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 1:1285 CONTINENTAL LINE LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8173
Mailing Address - Country:US
Mailing Address - Phone:610-793-9387
Mailing Address - Fax:
Practice Address - Street 1:1207 N SCOTT ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4059
Practice Address - Country:US
Practice Address - Phone:302-652-3353
Practice Address - Fax:302-656-9979
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0004380207W00000X
PAMD048518L207W00000X
MDD0046885207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE008878C37Medicare PIN