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Individual

LEONID KOTKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
280 WASHINGTON ST, STE. 207, BRIGHTON, MA 02135-3511
(617) 783-8875
(617) 782-3367
Mailing address
340 MAIN ST, SUITE 670, WORCESTER, MA 01608-1604
(508) 754-3566
(508) 438-6368

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
151270
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3159345
MA
Enumeration date
09/30/2005
Last updated
12/05/2011
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