Provider Demographics
NPI:1437184389
Name:KOSCICA, KAREN LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:KOSCICA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DAVIS AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4488
Mailing Address - Country:US
Mailing Address - Phone:732-775-4755
Mailing Address - Fax:732-776-4754
Practice Address - Street 1:19 DAVIS AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4488
Practice Address - Country:US
Practice Address - Phone:732-775-4755
Practice Address - Fax:732-776-4754
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB066840207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0009725Medicaid
NJ0009725Medicaid
NJH30150Medicare UPIN