Provider Demographics
NPI:1861998940
Name:KURIAKOSE, BESTIN (DO)
Entity type:Individual
Prefix:
First Name:BESTIN
Middle Name:
Last Name:KURIAKOSE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6608
Mailing Address - Country:US
Mailing Address - Phone:888-445-0680
Mailing Address - Fax:
Practice Address - Street 1:761 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6608
Practice Address - Country:US
Practice Address - Phone:888-444-6974
Practice Address - Fax:516-357-0087
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315827208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation