| Doctor Name: | BRIAN KOKULAK |
| NPI Number: | 1396129037 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 40QA01606100 |
| Business Practice Address: | 540 Lafayette Rd Suite B Sparta, NJ - 078713497 |
| Business Phone Number: | 9739408680 |
| Business Fax Number: | 9739408634 |
| Mailing Address: | 532 Lafayette Rd, Suite 300 SPARTA |
| State: | NJ |
| Postal Code: | 078714411 |
| Phone Number: | 9739400423 |
| Fax Number: | 9739400399 |
| NPI Enumeration Date: | 07/13/2015 |
| NPI Last Update Date: | 07/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01606100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |