Provider Demographics
NPI:1861774044
Name:KOSHY, PERSIS MARY
Entity type:Individual
Prefix:MRS
First Name:PERSIS
Middle Name:MARY
Last Name:KOSHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 TALL PINES DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1491
Mailing Address - Country:US
Mailing Address - Phone:610-653-8457
Mailing Address - Fax:
Practice Address - Street 1:301 CIRCLE OF PROGRESS DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3811
Practice Address - Country:US
Practice Address - Phone:610-970-5410
Practice Address - Fax:610-970-3330
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)