MEDICARE: BRITTNEY KOHLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NY

General Provider Information

NPI Number	:	1265256077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY KOHLER

Provider Business Mailing Address
First Line	:	45 CAMBRIDGE RD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11023-1506
Country	:	US
Telephone Number	:	516-606-6716
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 TIMES SQ
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-6564
Country	:	US
Telephone Number	:	212-463-0400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2024
Last Update Date	:	06/15/2026

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Directions to “ BRITTNEY KOHLER ” Practice Location

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