Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2164041 | NY |
N | 111NI0900X | Internist | 2164041 | NY |
Y | 207RI0200X | Infectious Disease | 2164041 | NY |
NPI | 1043295926 |
---|---|
Provider Name | Sanjana Koshy |
First Address | New York, NY 10017-5699 |
Second Address | New York, NY 10003-3314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 24/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02420886 | (05) | NY |
I00999 | (02) |