Provider Demographics
NPI:1033896121
Name:KOTSUKA, YOKO (LAC)
Entity Type:Individual
Prefix:MS
First Name:YOKO
Middle Name:
Last Name:KOTSUKA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3279 30TH ST APT 5J
Mailing Address - Street 2:
Mailing Address - City:LONG IS CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2910
Mailing Address - Country:US
Mailing Address - Phone:929-227-5653
Mailing Address - Fax:
Practice Address - Street 1:3279 30TH ST APT 5J
Practice Address - Street 2:
Practice Address - City:LONG IS CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-2910
Practice Address - Country:US
Practice Address - Phone:929-227-5653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007212171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist