National Provider Identifier

Diane Kottakis

Diane Kottakis is listed in the NPPES registry with a primary specialty of Physical Therapist in Clarence Center, NY and a listed phone number of (732) 995-7784.

NPI 1083064646Clarence Center, NYPhysical Therapist

Profile Overview

NPI
1083064646
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
June 15, 2016
Last Updated
June 15, 2016

Practice Location

  • 5999 Corinne Ln
  • Clarence Center, NY 14032-9517

Phone: (732) 995-7784

Specialties

  • Physical Therapist (225100000X)
Full Record
NPI
1083064646
Entity Type
Individual
Last Name
Kottakis
First Name
Diane
Mailing Street Address
5999 Corinne Ln
Mailing City
Clarence Center
Mailing State
NY
Mailing ZIP Code
14032-9517
Mailing Country
US
Mailing Phone
(732) 995-7784
Practice Street Address
5999 Corinne Ln
Practice City
Clarence Center
Practice State
NY
Practice ZIP Code
14032-9517
Practice Country
US
Practice Phone
(732) 995-7784
Enumeration Date
June 15, 2016
Last Updated
June 15, 2016
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X)
Other Identifiers
038586-1 (NY, Ny License)