Provider Demographics
NPI:1962891580
Name:KOTOWSKI, IZABELLA
Entity type:Individual
Prefix:
First Name:IZABELLA
Middle Name:
Last Name:KOTOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 AINSLIE ST APT 4F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-5084
Mailing Address - Country:US
Mailing Address - Phone:609-638-2849
Mailing Address - Fax:
Practice Address - Street 1:226 AINSLIE ST APT 4F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-5084
Practice Address - Country:US
Practice Address - Phone:609-638-2849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist