Individual
DR. PHYLLIS KOSSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
31 POLLY DRIVE, HUNTINGTON, NY 11743
(631) 423-1535
(631) 351-0445
Mailing address
31 POLLY DRIVE, HUNTINGTON, NY 11743
(631) 423-1535
(631) 351-0445
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
006747
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01354094
—
NY
Enumeration date
01/02/2007
Last updated
07/08/2007
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