Provider Demographics
NPI:1790774685
Name:KOSKINEN, KJERSTI (MD)
Entity Type:Individual
Prefix:DR
First Name:KJERSTI
Middle Name:
Last Name:KOSKINEN
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 1:1 MUNRO AVE
Mailing Address - Street 2:HSWL FO
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-5000
Mailing Address - Country:US
Mailing Address - Phone:609-898-6564
Mailing Address - Fax:
Practice Address - Street 1:1 MUNRO AVE
Practice Address - Street 2:HSWL FO
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-5000
Practice Address - Country:US
Practice Address - Phone:609-898-6567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054766A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine