| | Physician Last Name: | Koltovich |
| | Physician First Name: | Paul |
| | Physician Middle Name: | W. |
| | Address: | Address redacted |
| | License Number: | 185987 |
| | License Type: | MD |
| | Year of Birth: |
1960
|
| | Effective Date: | 03/26/2019 |
| | Action Description for DOH Webpage: | The physician’s New York State medical license is restored with conditions |
| | Misconduct Description for DOH Webpage: | This action is not disciplinary in nature.Previously on April 20, 2015 the physician’s New York State medical license was temporarily surrendered pursuant to New York State Public Health Law Section 230.13. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
|
