Provider Demographics
NPI:1073694147
Name:KOSTER, DIVYA (MD)
Entity Type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:
Last Name:KOSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:31 ROCHE BROTHERS WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1038
Mailing Address - Country:US
Mailing Address - Phone:508-894-8760
Mailing Address - Fax:508-894-0412
Practice Address - Street 1:31 ROCHE BROTHERS WAY STE 210
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1038
Practice Address - Country:US
Practice Address - Phone:508-894-8760
Practice Address - Fax:508-894-0412
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD12414208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI33636OtherNEIGHBORHOOD OF RI
RIAA98084OtherHARVARD PILGRIM
RI6770670OtherCIGNA