Healthcare Provider Details

I. General information

NPI: 1912917980
Provider Name (Legal Business Name): KOCHMANN COLLECTOR, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E PADONIA RD
TIMONIUM MD
21093-2306
US

IV. Provider business mailing address

PO BOX 525
MONKTON MD
21111-0525
US

V. Phone/Fax

Practice location:
  • Phone: 410-683-3330
  • Fax:
Mailing address:
  • Phone: 410-683-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANATOLI AMARANTIDIS COLLECTOR
Title or Position: PRACTICE MANAGER
Credential:
Phone: 410-683-3330