Individual
ANNA KOPACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
66-05 MYRTLE AVE, GLENDALE, NY 11385
(646) 912-5659
Mailing address
66-05 MYRTLE AVE, GLENDALE, NY 11385
(646) 912-5659
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
030535-1
NY
225100000X
Physical Therapist
Primary
030535-1
NY
Other
Enumeration date
10/15/2009
Last updated
11/02/2017
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