Provider Demographics
NPI:1760640676
Name:TUCZYNSKI, JULIA ANNE KOSSTRIN (PT)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ANNE KOSSTRIN
Last Name:TUCZYNSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:ANNE
Other - Last Name:KOSSTRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:39 HOSPITAL CENTER CMNS
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2837
Mailing Address - Country:US
Mailing Address - Phone:843-689-2233
Mailing Address - Fax:843-689-2234
Practice Address - Street 1:39 HOSPITAL CENTER CMNS
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2837
Practice Address - Country:US
Practice Address - Phone:843-689-2233
Practice Address - Fax:843-689-2234
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026708 1225100000X
SC11849225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist