Healthcare Provider Details

I. General information

NPI: 1215028337
Provider Name (Legal Business Name): WILLIAM GREGORY KOSHINSKIE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 ATLANTIC AVE STE 302
OCEAN VIEW DE
19970-9163
US

IV. Provider business mailing address

118 ATLANTIC AVE STE 302
OCEAN VIEW DE
19970-9163
US

V. Phone/Fax

Practice location:
  • Phone: 302-537-7762
  • Fax: 302-537-7488
Mailing address:
  • Phone: 302-537-7762
  • Fax: 302-537-7488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011776L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0002600
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: