Healthcare Provider Details

I. General information

NPI: 1306963137
Provider Name (Legal Business Name): BELINDA JOAN KOTIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7559 263RD ST HILLSIDE HOSPITAL-AMBULATORY CARE PAVILLION, #1304
GLEN OAKS NY
11004-1150
US

IV. Provider business mailing address

7031 108TH ST APRT. 7F
FOREST HILLS NY
11375-4450
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-4566
  • Fax:
Mailing address:
  • Phone: 718-261-1045
  • Fax: 718-261-1045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberF400798-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: