Basic Information
| Provider Information | |||||||||
| NPI: | 1851496681 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KO | ||||||||
| FirstName: | WILLIAM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 ROUTE 66 | ||||||||
| Address2: | FL 3 | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077532605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328078077 | ||||||||
| FaxNumber: | 2017511680 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 RIVERVIEW PLZ | ||||||||
| Address2: | |||||||||
| City: | RED BANK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077011864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325302305 | ||||||||
| FaxNumber: | 7322248410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 07/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 25MA06878200 | NJ | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.