Basic Information
Provider Information
NPI: 1750426490
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOSHY
FirstName: RACHEL
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: VERGHESE
OtherFirstName: RACHEL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 854
Address2: MC A410
City: HERSHEY
State: PA
PostalCode: 170330854
CountryCode: US
TelephoneNumber: 8002431455
FaxNumber: 7175316934
Practice Location
Address1: 500 UNIVERSITY DR
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 8002431455
FaxNumber: 7175316934
Other Information
ProviderEnumerationDate: 02/20/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XLT000620PAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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