Individual
DAVID KOTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
263 FARMINGTON AVE, NEUROSURGERY, FARMINGTON, CT 06030-0001
(860) 679-4719
(860) 679-1419
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT OFFICE, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
000030
CT
Other
Enumeration date
07/12/2005
Last updated
09/29/2022
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