Individual
ASHLEY KOSARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 CHESTNUT PL, MASTIC BEACH, NY 11951-7201
(631) 413-2215
Mailing address
7 CHESTNUT PL, MASTIC BEACH, NY 11951-7201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1146372
NY
Other
Enumeration date
06/30/2012
Last updated
06/30/2012
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