Provider Demographics
NPI:1003798596
Name:KOSHY, MARISSA ANN (PA-C)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:ANN
Last Name:KOSHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 CITY WALLS ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-1695
Mailing Address - Country:US
Mailing Address - Phone:919-348-0294
Mailing Address - Fax:
Practice Address - Street 1:820 CITY WALLS ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-1695
Practice Address - Country:US
Practice Address - Phone:919-348-0294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant