Provider Demographics
NPI:1326137720
Name:KOTSAR, VITA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:VITA
Middle Name:
Last Name:KOTSAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 E 28TH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2448
Mailing Address - Country:US
Mailing Address - Phone:718-769-1012
Mailing Address - Fax:
Practice Address - Street 1:1201 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 1 B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-1216
Practice Address - Country:US
Practice Address - Phone:718-642-8955
Practice Address - Fax:718-942-1721
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065723-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical