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General NPI Number Information
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NPI Number | 1912782111
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Entity Type | Individual
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Provider Name | SHANA KOH
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Gender | Female
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 139 CHAMBERS ST
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City | NEW YORK
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State | NY
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Zip | 10007-1006
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Country | US
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Telephone | 212-785-0001
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Fax |
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Provider Business Mailing Address
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Address Line | 400 LINCOLN PL APT 4G
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City | BROOKLYN
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State | NY
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Zip | 11238-5805
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Country | US
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Telephone | 929-344-9595
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F352261-01
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License Number State | NY
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