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General NPI Number Information
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NPI Number | 1255782488
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Entity Type | Individual
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Provider Name | NANCY KOSHY
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Gender | Female
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 504 WHITE HORSE PIKE
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City | HADDON HEIGHTS
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State | NJ
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Zip | 08035-1709
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Country | US
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Telephone | 856-546-7990
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST STE 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 848-288-6935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB10747400
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License Number State | NJ
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