Provider Demographics
NPI:1881967891
Name:KOCHERSPERGER, REBECCA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:KOCHERSPERGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:157-105-1812
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD STE 225
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1237
Practice Address - Country:US
Practice Address - Phone:215-710-6613
Practice Address - Fax:215-710-6614
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054928363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical