Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Main Sen Koo

Individual provider Physician Assistant · NPI 1609737196

Main Sen Koo is a Physician Assistant in Elmhurst, New York. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025

Practice location Address checks out

7901 Broadway
Elmhurst, NY 11373-1329
Phone: (844) 692-4692
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 035062 (NY)

Record details

NPI number1609737196
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 24, 2025
Last updated in NPPESDecember 28, 2025
Certification dateDecember 28, 2025
Mailing address3708 Main St Ste 209, Flushing, NY 11354-6537

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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