National Provider Identifier

Merlyn Jacob Koshy, PA

Merlyn Jacob Koshy, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Elmira, NY and a listed phone number of (607) 737-4508.

NPI 1780082313Elmira, NYPhysician Assistant

Profile Overview

NPI
1780082313
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
December 13, 2014
Last Updated
November 25, 2020

Practice Location

  • 600 Roe Avenue
  • Elmira, NY 14905-1629

Phone: (607) 737-4508

Mailing Address

  • 571 Saint Josephs Blvd Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1780082313
Entity Type
Individual
Last Name
Koshy
First Name
Merlyn
Middle Name
Jacob
Name Prefix
Mrs.
Credential
PA
Provider Other Last Name
Jacob
Provider Other First Name
Merlyn
Provider Other Name Prefix Text
Mrs.
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
571 Saint Josephs Blvd Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 873-1244
Practice Street Address
600 Roe Avenue
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1629
Practice Country
US
Practice Phone
(607) 737-4508
Practice Fax
(607) 735-5738
Enumeration Date
December 13, 2014
Last Updated
November 25, 2020
Sex
Female
Sole Proprietor
No
Certification Date
November 25, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X)
Other Identifiers
103367085 (PA), 04342201 (NY)