Individual
DR. DAVID KOTARSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
25700 SCIENCE PARK DR STE 200, BEACHWOOD, OH 44122-7328
(216) 831-1040
(216) 831-2667
Mailing address
PO BOX 96, MC CLELLANDTOWN, PA 15458-0096
(412) 582-6296
(855) 737-2544
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6726
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3134021
—
OH
01
—
6726
LICENSED PSYCHOLOGIST
OH
01
—
CP35441
MEDICARE PTAN
OH
Enumeration date
01/03/2011
Last updated
05/04/2023
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