=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629044011
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DORRIT ARIA COCH M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4815 14TH AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11219-3119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-854-2144
-----------------------------------------------------
Fax | 718-854-1500
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 337 MAYFAIR DR N
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11234-6715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-531-1791
-----------------------------------------------------
Fax | 718-531-1723
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 115042
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------