Organization
LEONID KOTKIN, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONID KOTKIN M.D. (PRESIDENT)
(617) 783-8875
Entity
Organization
Contact information
Practice address
280 WASHINGTON ST, STE. 207, BRIGHTON, MA 02135-3511
(617) 783-8875
Mailing address
340 MAIN ST, STE. 670, WORCESTER, MA 01608-1604
(508) 754-3566
(508) 438-6368
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
200208861
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9755161
—
MA
Enumeration date
08/18/2006
Last updated
12/05/2011
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