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General NPI Number Information
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NPI Number | 1306709266
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Entity Type | Individual
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Provider Name | JEFFIN K KOSHY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | N86W12999 NIGHTINGALE WAY
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2102
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Country | US
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Telephone | 414-805-5690
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Fax |
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Provider Business Mailing Address
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Address Line | 630 LONGFORD DR
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City | DES PLAINES
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State | IL
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Zip | 60016-8743
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2319440
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 32494
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051305808
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License Number State | IL
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