Provider Demographics
NPI:1942610274
Name:KOKA CARDIOLOGY PC
Entity Type:Organization
Organization Name:KOKA CARDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-543-7002
Mailing Address - Street 1:125 S 9TH ST STE 1005
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5123
Mailing Address - Country:US
Mailing Address - Phone:215-543-7002
Mailing Address - Fax:215-987-5891
Practice Address - Street 1:125 S 9TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19107-5125
Practice Address - Country:US
Practice Address - Phone:215-543-7002
Practice Address - Fax:215-987-5891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty