Provider Demographics
NPI:1629729439
Name:KOTULA, STEVEN PAUL
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PAUL
Last Name:KOTULA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 STATE ROUTE 79
Mailing Address - Street 2:
Mailing Address - City:RICHFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13835-1814
Mailing Address - Country:US
Mailing Address - Phone:607-657-4462
Mailing Address - Fax:
Practice Address - Street 1:1643 STATE ROUTE 79
Practice Address - Street 2:
Practice Address - City:RICHFORD
Practice Address - State:NY
Practice Address - Zip Code:13835-1814
Practice Address - Country:US
Practice Address - Phone:607-657-4462
Practice Address - Fax:607-657-4462
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist