MEDICARE: KARLA BURLESON COTA/L

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	011748	NY

General Provider Information

NPI Number	:	1215818067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA BURLESON COTA/L

Provider Business Mailing Address
First Line	:	24719 90TH AVE
Second Line	:
City	:	BELLEROSE
State	:	NY
Zip	:	11426-1507
Country	:	US
Telephone Number	:	516-242-6272
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 MERRICK RD
Second Line	:
City	:	BALDWIN
State	:	NY
Zip	:	11510-3354
Country	:	US
Telephone Number	:	516-744-7550
Fax Number	:

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

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	09/09/2025

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