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General NPI Number Information
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NPI Number | 1851328330
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Entity Type | Individual
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Provider Name | KOSTA KOKOLIS M.S., P.T.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | 110 E 23RD ST 3RD FLOOR
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City | NEW YORK
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State | NY
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Zip | 10010-4517
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Country | US
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Telephone | 212-529-5700
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Fax | 212-529-3415
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Provider Business Mailing Address
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Address Line | 4106 BELL BLVD 2ND FLOOR
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City | BAYSIDE
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State | NY
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Zip | 11361-2857
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Country | US
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Telephone | 718-279-9800
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Fax | 718-279-9500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 023936-1
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License Number State | NY
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