Healthcare Provider Details
I. General information
NPI: 1801081831
Provider Name (Legal Business Name): HERSCHEL KOTKES MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2007
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
45 WEYANT DR
CEDARHURST NY
11516-2514
US
IV. Provider business mailing address
45 WEYANT DR
CEDARHURST NY
11516-2514
US
V. Phone/Fax
- Phone: 212-319-1339
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 221937 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 221937 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 221937 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
TZVI
HERSCHEL
KOTKES
Title or Position: OWNER
Credential: M.D.
Phone: 212-319-1339