MEDICARE: RACHEL EPP COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1063061802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL EPP COTA

Provider Business Mailing Address
First Line	:	15 UPLAND DR
Second Line	:
City	:	CORNING
State	:	NY
Zip	:	14830-3334
Country	:	US
Telephone Number	:	607-742-3174
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 E MARKET ST
Second Line	:
City	:	CORNING
State	:	NY
Zip	:	14830-2708
Country	:	US
Telephone Number	:	607-742-3174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2019
Last Update Date	:	09/04/2019

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Directions to “ RACHEL EPP COTA” Practice Location

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