Kossak, Phyllis

Kossak, Phyllis is an individual health care provider with primary practice located at 31 Polly Drive , Huntington NY 11743. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Kossak, Phyllis can be contacted via phone (631) 423-1535.

Contact Information

Primary practice address
31 Polly Drive Huntington NY 11743
Fax: (631) 351-0445
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 006747 New York

Profile Details

NPI number 1245397918
LBN Legal business name Kossak, Phyllis
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245397918 NPPES
New York MEDICAID 01354094

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