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Individual
TODD J KOTYK
Active
Individual
TODD J KOTYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2484
WV
225100000X
Physical Therapist
Primary
PT-009765-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11513356
CAQH PROVIDER ID
—
01
—
1279105
AETNA HMO PROVIDER NUMBER
—
01
—
5139764
AETNA PIN PPO PRODUCTS
—
01
—
KO425781
HIGHMARK BLUE SHIELD
PA
Enumeration date
05/02/2007
Last updated
07/08/2007
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