Healthcare Provider Details

I. General information

NPI: 1710929138
Provider Name (Legal Business Name): GEORGE J KOCMAN JR. MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 MAURICE ST
YORK PA
17404-1386
US

IV. Provider business mailing address

626 MAURICE ST
YORK PA
17404-1386
US

V. Phone/Fax

Practice location:
  • Phone: 717-801-1600
  • Fax: 717-801-1600
Mailing address:
  • Phone: 717-801-1600
  • Fax: 717-801-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS007141L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: