| Doctor Name: | MRS. THERESA MARIE KOTASH |
| NPI Number: | 1073782595 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPN |
| License Number: | 2880831 |
| Business Practice Address: | 71 Brown Rd Wappingers Falls, NY - 12590 |
| Business Phone Number: | 8455920591 |
| Business Fax Number: | |
| Mailing Address: | 71 Brown Road, WAPPINGERS FALLS |
| State: | NY |
| Postal Code: | 12590 |
| Phone Number: | 8455920591 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2008 |
| NPI Last Update Date: | 02/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 2880831 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |