Individual
DR. JEANNE MARY KOTUBY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
135 PROSPECT PARK W, #44A, BROOKLYN, NY 11215-4267
(718) 788-6886
Mailing address
135 PROSPECT PARK W, #44A, BROOKLYN, NY 11215-4267
(718) 788-6886
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016044
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257029
COMPSYCH
—
01
—
P3587910
OXFORD HEALTH PLANS
—
Enumeration date
01/16/2006
Last updated
07/08/2007
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