Tara Ann Koch, P.A.
Physician Assistant in Woodbury, NY. Individual provider (NPI-1).
NPI number1497908487
StatusActive
Last updated in NPPESFeb 3, 2016
Details
- NPI
- 1497908487
- Entity type
- Individual (NPI-1)
- Name
- Tara Ann Koch
- Credential
- P.A.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 4, 2008
- Last updated
- Feb 3, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 012983 | NY | Yes |
Practice location
800 Woodbury RdWoodbury, NY 11797-2503
Phone 516-496-9400 · Fax 516-496-9212
Mailing address
16 Harding StSmithtown, NY 11787-5523
Phone 917-710-3397
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physician Assistant providers in Woodbury, NY
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- Theresa M Gentile, RPA-CNPI 1841418480
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All 11 Physician Assistant providers in Woodbury · All 619 providers in Woodbury
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