Provider Demographics
NPI:1770536849
Name:KO, EUGENE CH (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:CH
Last Name:KO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 N READING RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-9802
Mailing Address - Country:US
Mailing Address - Phone:717-733-6546
Mailing Address - Fax:717-733-6010
Practice Address - Street 1:464 HUDSON TER
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2902
Practice Address - Country:US
Practice Address - Phone:973-705-4914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038468E207R00000X
NJ25MA10726600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00324585OtherRAILROAD MEDICARE
PA196033FLTOtherMEDICARE
PA0010964090016Medicaid
PA196033OtherBLUE SHIELD
PA196033UFWMedicare PIN
PAC33276Medicare UPIN