Individual
BLESSY KOSHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6000 N BROAD ST, PHILADELPHIA, PA 19141-1900
(215) 424-4005
(215) 424-7660
Mailing address
6000 N BROAD ST, PHILADELPHIA, PA 19141-1900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA002688
PA
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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