Provider Demographics
NPI:1285788752
Name:KOCHMAN, MARY KAY (AUD)
Entity type:Individual
Prefix:DR
First Name:MARY KAY
Middle Name:
Last Name:KOCHMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 E GOLDEN CT
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1653
Mailing Address - Country:US
Mailing Address - Phone:480-899-2396
Mailing Address - Fax:
Practice Address - Street 1:595 N DOBSON RD STE D79
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4234
Practice Address - Country:US
Practice Address - Phone:480-899-0076
Practice Address - Fax:480-786-0152
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1468237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ27695Medicare ID - Type Unspecified