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General NPI Number Information
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NPI Number | 1134847403
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Entity Type | Individual
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Provider Name | KAITLYN KOEHLER PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 12 W 21ST ST FL 6
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City | NEW YORK
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State | NY
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Zip | 10010-6914
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Country | US
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Telephone | 212-343-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 12 W 21ST ST FL 6
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City | NEW YORK
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State | NY
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Zip | 10010-6914
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Country | US
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Telephone | 212-343-2222
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Fax | 646-455-1965
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 028432
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License Number State | NY
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