Koch, Glenn R

Koch, Glenn R is an individual health care provider with primary practice located at 961 Marcon Blvd , Allentown PA 18109. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Koch, Glenn R can be contacted via phone (610) 266-0610.

Contact Information

Primary practice address
961 Marcon Blvd Allentown PA 18109
Phone: (610) 266-0610
Fax: (610) 266-0293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS005286L Pennsylvania

Profile Details

NPI number 1093854309
LBN Legal business name Koch, Glenn R
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jul 8th, 2007 - about 18 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 1093854309 NPPES
Other 01979901 INDIVIDUAL
MEDICAID 0016509210002 INDIVIDUAL
Other 02817200 INDIVIDUAL
Other 0453403000 INDIVIDUAL
Other GL1454227 INDIVIDUAL

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