Provider Demographics
NPI:1598245920
Name:KOSHIYA, SACHIN (PT MS DPT)
Entity Type:Individual
Prefix:
First Name:SACHIN
Middle Name:
Last Name:KOSHIYA
Suffix:
Gender:M
Credentials:PT MS DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MAKEFIELD RD STE 10
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5967
Mailing Address - Country:US
Mailing Address - Phone:267-797-1699
Mailing Address - Fax:267-379-0157
Practice Address - Street 1:85 MAKEFIELD RD STE 10
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5967
Practice Address - Country:US
Practice Address - Phone:267-797-1699
Practice Address - Fax:267-379-0157
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028140225100000X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT028140OtherSTATE LICENSE