Provider Demographics
NPI:1770955064
Name:KOSHY, SHERIN ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:SHERIN
Middle Name:ANN
Last Name:KOSHY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27107 77TH RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1427
Mailing Address - Country:US
Mailing Address - Phone:917-373-8604
Mailing Address - Fax:
Practice Address - Street 1:27107 77TH RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1427
Practice Address - Country:US
Practice Address - Phone:917-373-8604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020098225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist