Healthcare Provider Details

I. General information

NPI: 1073535589
Provider Name (Legal Business Name): MADHAVI KOKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/18/2026
Certification Date: 01/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 GRASSLANDS RD-NYMC DEPT OF MEDICINE-MUNGER PAVILION
VALHALLA NY
10595
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-8370
  • Fax: 914-594-4434
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA100644
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: