Provider Demographics
NPI:1255097416
Name:KAN, KOCHEE
Entity type:Individual
Prefix:
First Name:KOCHEE
Middle Name:
Last Name:KAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 NEW ENGLAND WOODS DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2910
Mailing Address - Country:US
Mailing Address - Phone:571-789-3045
Mailing Address - Fax:240-559-9030
Practice Address - Street 1:5900 NEW ENGLAND WOODS DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2910
Practice Address - Country:US
Practice Address - Phone:571-789-3045
Practice Address - Fax:240-559-9030
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health