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Individual

DR. LAWRENCE ROBERT KOTKIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
61 WILMINGTON DR, MELVILLE, NY 11747-4032
(631) 643-0924
(631) 491-9110
Mailing address
61 WILMINGTON DR, MELVILLE, NY 11747-4032
(631) 643-0924
(631) 491-9110

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
6339
NY
103TB0200X
Cognitive & Behavioral Psychologist
6339
NY
103TC0700X
Clinical Psychologist
Primary
6339
NY
103TF0000X
Family Psychologist
6339
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
087600
VALUE OPTIONS
NY
01
104024000
MAGELLAN HEALTH PLANS
NY
01
35296
VYTRA BEHAVIORAL HEALTH
NY
01
87726
UNITED BEHAVIORAL HEALTH
NY
01
AS217
OXFORD HEALTH PLANS
NY
Enumeration date
10/26/2006
Last updated
01/14/2010
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