| D Koby Inc | |
|
620 Lacey Rd Ste 5 Forked River NJ 08731-2244 | |
| (908) 405-2117 | |
| Not Available |
| Full Name | D Koby Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 620 Lacey Rd Ste 5, Forked River, New Jersey |
| Authorized Official Name and Position | Donna Marie Koby (OWNER) |
| Authorized Official Contact | 9084052117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| D Koby Inc 620 Lacey Rd Ste 5 Forked River NJ 08731-2244 Ph: (908) 405-2117 | D Koby Inc 620 Lacey Rd Ste 5 Forked River NJ 08731-2244 Ph: (908) 405-2117 |
| NPI Number | 1396416715 |
|---|---|
| Provider Enumeration Date | 09/24/2021 |
| Last Update Date | 04/14/2022 |
| Certification Date | 04/14/2022 |
| Medicare PECOS PAC ID | 8224427943 |
|---|---|
| Medicare Enrollment ID | O20211117002366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396416715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Donna M Koby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639722242 PECOS PAC ID: 9739419813 Enrollment ID: I20191003000436 |
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