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NPI Code Detail

MEDICARE: MRS. LETICIA K. CHY-KOA MD

MEDICARE:  MRS. LETICIA K. CHY-KOA  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
1174400000XSpecialist01024246IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669579181
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LETICIA K. CHY-KOA MD
Provider Business Mailing Address
First Line : 1951 W. GLEN PARK AVENUE
Second Line :
City : GRIFFITH
State : IN
Zip : 46319-3703
Country : US
Telephone Number : 219-924-5004
Fax Number : 219-924-5358
Provider Business Practice Location Address
First Line : 1951 W. GLEN PARK AVENUE
Second Line :
City : GRIFFITH
State : IN
Zip : 46319-3703
Country : US
Telephone Number : 219-924-5004
Fax Number : 219-924-5358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2006
Last Update Date : 02/02/2009

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Directions to “ MRS. LETICIA K. CHY-KOA MD” Practice Location

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