Mia Chwan Ko

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

OS018906 Issued in PA

Practice address

5401 Old York Rd Ste 404
Philadelphia, PA 19141-3046

Phone

(856) 342-2445

NPI assigned

Jun 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD (past)

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1942613369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E HECTOR ST UNIT 434",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282456",
            "telephone_number": "646-709-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD YORK RD STE 404",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413046",
            "telephone_number": "856-342-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "MIA",
        "middle_name": "CHWAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OS018906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eun Byul Ko
• Gang I Ko, DMD
• Hanjo Ko
• Janet Jinyoung Ko, MD
• Jocelyn Ko, MD
• Stephanie Ko, MD
• Yiuman Ko, D.M.D.
• Benjamin David Koa
• Kristen N Kobaly, MD
• Taisei John Kobayashi, MD

• Neurology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Neurology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.