Individual provider · Type 1 NPI

Matthew Peter Koss, PA-C

Surgical Physician Assistant · Staten Island, NY

NPI number 1154670263 Active

Practice location

475 Seaview Ave
Staten Island, NY 10305-3498

Mailing address

354 Cromwell Ave.
Staten Island, NY 10305

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X015867 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1154670263

Matthew Peter Koss, PA-C's National Provider Identifier is 1154670263, issued on Sep 5, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Staten Island, NY. The record was last updated on Sep 5, 2012.