Nicholas Theodore Koen
Nicholas Theodore Koen is a Student in an Organized Health Care Education/Training Program in Worcester, Massachusetts. Practices as a sole proprietor. Licensed in Massachusetts.
- Licensed in
- MA
- In the registry since
- 2020
- Specialties on file
- 2
Practice location Address checks out
55 Lake Ave NWorcester, MA 01655-0002
Phone: (978) 223-8500
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Specialties & licences
| Internal Medicine Physician (primary) | Taxonomy 207R00000X · Licence 294457 (MA) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1962031856 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 3, 2020 |
| Last updated in NPPES | December 5, 2024 |
| Certification date | December 5, 2024 |
| Mailing address | 55 Lake Ave N, Worcester, MA 01655-0002 |
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