Provider Demographics
NPI:1114925708
Name:KOSHY, BINNY (MD)
Entity Type:Individual
Prefix:DR
First Name:BINNY
Middle Name:
Last Name:KOSHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4198
Mailing Address - Country:US
Mailing Address - Phone:516-745-0500
Mailing Address - Fax:516-745-1534
Practice Address - Street 1:300 OLD COUNTRY RD
Practice Address - Street 2:SUITE 111
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4198
Practice Address - Country:US
Practice Address - Phone:516-745-0500
Practice Address - Fax:516-745-1534
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225184207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02671850Medicaid
NYH73688Medicare UPIN
NY02671850Medicaid