Healthcare Provider Details

I. General information

NPI: 1821739582
Provider Name (Legal Business Name): KEVIN QOSJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 SEAVIEW AVE BLDG 8/9
STATEN ISLAND NY
10305-3409
US

IV. Provider business mailing address

777 SEAVIEW AVE BLDG 8/9
STATEN ISLAND NY
10305-3409
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-2300
  • Fax:
Mailing address:
  • Phone: 718-667-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number332061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: