Healthcare Provider Details

I. General information

NPI: 1780627968
Provider Name (Legal Business Name): JANET JINYOUNG KO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/11/2020
Certification Date: 07/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 OLD YORK RD KLEIN 410
PHILADELPHIA PA
19141-3030
US

IV. Provider business mailing address

609 W GERMANTOWN PIKE STE 220
EAST NORRITON PA
19403-4261
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-6990
  • Fax: 215-456-6967
Mailing address:
  • Phone: 484-622-7940
  • Fax: 484-622-7950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD428999
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: