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Contact Information

BRIAN KOCH
1 BAY ST
GLEN RIDGE, NJ07028-1505
 Phone: 925-595-1994
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for BRIAN KOCH · (Male)

NPI Number 1972998417
Status Active
Credentials
Entity Individual
Enumeration date 04/01/2015
Last updated 09/20/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A149062
  • NJ License # 25MA10240700
Hospital affiliation(s)
  • HACKENSACK UMC MOUNTAINSIDE - (Acute Care)
    BAY AND HIGHLAND AVE
    MONTCLAIR, NJ 07042
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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