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NPI Code Detail

MEDICARE: RICHARD CHARLES KOVACH MD

MEDICARE: RICHARD CHARLES KOVACH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician25MA05149000NJ
2207RC0000XCardiovascular Disease PhysicianMD029467EPA

General Provider Information

NPI Number : 1144209891
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD CHARLES KOVACH MD
Provider Business Mailing Address
First Line : 1 GUTHRIE SQ
Second Line :
City : SAYRE
State : PA
Zip : 18840-1625
Country : US
Telephone Number : 570-888-5858
Fax Number : 570-882-3007
Provider Business Practice Location Address
First Line : 200 TRENTON RD
Second Line :
City : BROWNS MILLS
State : NJ
Zip : 08015-1705
Country : US
Telephone Number : 609-893-6611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 04/03/2018

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