Dr. Kern S. Koo, General &Family Medicine, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

221288 Issued in NY

Legal business name

DR. KERN S. KOO, GENERAL &FAMILY MEDICINE, P.C.

Practice address

5133 Marathon Pkwy
Little Neck, NY 11362-1716

Phone

(718) 357-3458

Fax

(718) 357-3483

NPI assigned

Sep 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kern Scott Koo, D.O.NPI 1679797088

Title

President

Phone

(718) 357-3458

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kern Scott Koo, D.O.

  • Family Medicine Physician
  • Little Neck, NY
  • NPI 1679797088
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1457501082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5133 MARATHON PKWY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621716",
            "telephone_number": "718-357-3458",
            "fax_number": "718-357-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5133 MARATHON PKWY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621716",
            "telephone_number": "718-357-3458",
            "fax_number": "718-357-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KERN S. KOO, GENERAL &FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "KERN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-357-3458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "221288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kean A Dey Foy
• Jillian L Diaz Panzella, CHHC
• Kathy Nathalie Diaz-Hines, LCSW
• Emily Ann Dibari, SLP-CCC
• Douglaston Community Pharmacy RX Inc
• Harriet C Duffy, OTR/L
• Durable Health Medical Supply LLC
• Dynasty Acupuncture P.C.
• Allison Ehlers
• Steven Howard Eisenberg, D.D.S.

• Primary Care Clinic/Center in Little Neck, NY
• Providers in Little Neck, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.