Provider Demographics
NPI:1184094294
Name:AGK PHYSICAL THERAPY AND ACUPUNCTURE PLLC
Entity type:Organization
Organization Name:AGK PHYSICAL THERAPY AND ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTLYARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-277-3252
Mailing Address - Street 1:80 BROAD ST STE 1401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2209
Mailing Address - Country:US
Mailing Address - Phone:347-277-3252
Mailing Address - Fax:646-861-2869
Practice Address - Street 1:80 BROAD ST STE 1401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2209
Practice Address - Country:US
Practice Address - Phone:347-277-3252
Practice Address - Fax:646-861-2869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003713171100000X
NY026795225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty