Provider Demographics
NPI:1457681546
Name:KOSOVSKY, KLARA (DPT)
Entity Type:Individual
Prefix:
First Name:KLARA
Middle Name:
Last Name:KOSOVSKY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 E 17TH ST
Mailing Address - Street 2:APARTMENT 5J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4453
Mailing Address - Country:US
Mailing Address - Phone:917-402-9892
Mailing Address - Fax:718-646-9038
Practice Address - Street 1:2915 AVENUE S
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2544
Practice Address - Country:US
Practice Address - Phone:718-554-3680
Practice Address - Fax:718-874-2625
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032092-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist