Healthcare Provider Details

I. General information

NPI: 1164416418
Provider Name (Legal Business Name): ISRAEL N KOCHIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 E 7TH ST
BROOKLYN NY
11230-5103
US

IV. Provider business mailing address

1321 E 7TH ST
BROOKLYN NY
11230-5103
US

V. Phone/Fax

Practice location:
  • Phone: 718-338-1313
  • Fax: 718-338-7777
Mailing address:
  • Phone: 718-338-1313
  • Fax: 718-338-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number221100
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number221100
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: