Provider Demographics
NPI:1609019348
Name:KOSHY, MARIA THOTTUNGAL (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:THOTTUNGAL
Last Name:KOSHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 WYNDHAM DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-4913
Mailing Address - Country:US
Mailing Address - Phone:916-525-6234
Mailing Address - Fax:
Practice Address - Street 1:7300 WYNDHAM DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4913
Practice Address - Country:US
Practice Address - Phone:916-525-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1248872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry