Individual
MRS. MELISSA ANNE KOSTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2277 GOSHEN TPKE, MIDDLETOWN, NY 10941-4032
(845) 692-4391
Mailing address
23 RANDALL PLZ, PORT JERVIS, NY 12771-3126
(845) 858-0664
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005933-1
NY
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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