Healthcare Provider Details

I. General information

NPI: 1225029069
Provider Name (Legal Business Name): RESOURCE ANESTHESIOLOGY OF PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 PERKIOMEN AVE
READING PA
19606-9614
US

IV. Provider business mailing address

10 COMMERCE DR
NEW ROCHELLE NY
10801-5214
US

V. Phone/Fax

Practice location:
  • Phone: 914-637-3510
  • Fax:
Mailing address:
  • Phone: 914-637-3510
  • Fax: 914-633-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MARC KOCH
Title or Position: PRESIDENT CEO
Credential: MD
Phone: 914-633-3287