Healthcare Provider Details

I. General information

NPI: 1801721402
Provider Name (Legal Business Name): KOTBI PSYCHIATRY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 KISCO AVE
MOUNT KISCO NY
10549-1415
US

IV. Provider business mailing address

120 KISCO AVE
MOUNT KISCO NY
10549-1415
US

V. Phone/Fax

Practice location:
  • Phone: 212-470-7801
  • Fax: 212-470-7801
Mailing address:
  • Phone: 212-470-7801
  • Fax: 212-470-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: NABIL KOTBI
Title or Position: OWNER
Credential: MD
Phone: 212-470-7801