Neither Dr. Kostenboym nor his nurses speak English as their primary language and this made it very difficult as an English-speaking patient. As a result, all case history and diagnosis was plowed through with little comprehension on both sides. When it came time for blood work, the nurse was incapable of keeping the needle still (excruciating) or of filling the blood vials without squeezing my arm to "pump" out more blood. When it was over, she couldn't understand why I was in pain. I will never set foot in that office again.