Provider Demographics
NPI:1023472727
Name:KOTEL, GAIL (MPT)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:KOTEL
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 1:519 S 9TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1331
Mailing Address - Country:US
Mailing Address - Phone:215-834-9799
Mailing Address - Fax:
Practice Address - Street 1:519 S 9TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19147-1331
Practice Address - Country:US
Practice Address - Phone:215-834-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012977L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist