Koch, Gary

Koch, Gary is an sole proprietor health care provider with primary practice located at 500 Market St Ste 204B , Beaver PA 15009. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Koch, Gary can be contacted via phone (724) 728-6670.

Contact Information

Primary practice address
500 Market St Ste 204B Beaver PA 15009
Phone: (724) 728-6670
Fax: (724) 728-5570
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X PS018065 Pennsylvania
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PS018065 Pennsylvania

Profile Details

NPI number 1861845208
LBN Legal business name Koch, Gary
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2016
Last updated Jul 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861845208 NPPES
Pennsylvania MEDICAID 1032369400002

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