Individual
DIANA KOLTSOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3437 WEIDNER AVE, OCEANSIDE, NY 11572-3536
(347) 422-4867
Mailing address
3437 WEIDNER AVE, OCEANSIDE, NY 11572-3536
(347) 422-4867
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
039160-1
NY
Other
Enumeration date
09/21/2016
Last updated
10/19/2023
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