Provider Demographics
NPI:1659345312
Name:KOKOSINSKI, EILEEN ROSE (MPT)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:ROSE
Last Name:KOKOSINSKI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 APASUS TRL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7700
Mailing Address - Country:US
Mailing Address - Phone:757-631-9414
Mailing Address - Fax:
Practice Address - Street 1:620 JHN PAUL JNS CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-3380
Practice Address - Fax:757-953-0809
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist