Provider Demographics
NPI:1578981155
Name:KOSHY, LINDA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:KOSHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8718 BAY PARKWAY
Mailing Address - Street 2:FLOORS 1 AND 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6402
Mailing Address - Country:US
Mailing Address - Phone:718-266-0900
Mailing Address - Fax:
Practice Address - Street 1:8718 BAY PARKWAY
Practice Address - Street 2:FLOORS 1 AND 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6402
Practice Address - Country:US
Practice Address - Phone:718-266-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY288443207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY46-1425115OtherTAX ID