Healthcare Provider Details

I. General information

NPI: 1558298612
Provider Name (Legal Business Name): JENCY KOSHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N EWING ST STE 304
LANCASTER OH
43130-3379
US

IV. Provider business mailing address

135 N EWING ST STE 304
LANCASTER OH
43130-3379
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-8397
  • Fax: 740-654-4103
Mailing address:
  • Phone: 740-687-8397
  • Fax: 740-654-4103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number58.035841
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: