Provider Demographics
NPI:1558971028
Name:KOVACS, LASZLO (OTA)
Entity Type:Individual
Prefix:MR
First Name:LASZLO
Middle Name:
Last Name:KOVACS
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 FOX RDG
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2830
Mailing Address - Country:US
Mailing Address - Phone:516-830-0918
Mailing Address - Fax:
Practice Address - Street 1:2420 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3444
Practice Address - Country:US
Practice Address - Phone:718-352-2100
Practice Address - Fax:718-352-3654
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005408224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant