Provider Demographics
NPI:1669634648
Name:KO, STEPHEN CHII-MING (MD MA MPH MDIV)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CHII-MING
Last Name:KO
Suffix:
Gender:M
Credentials:MD MA MPH MDIV
Other - Prefix:
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Mailing Address - Street 1:525 EAST 68TH STREET
Mailing Address - Street 2:HT 510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-746-3320
Mailing Address - Fax:212-746-8503
Practice Address - Street 1:1 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557-1406
Practice Address - Country:US
Practice Address - Phone:508-693-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2024-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2389932083P0901X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine