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NPI Code Detail

MEDICARE: MS. GINA MARIE WILLIAMS COTA

MEDICARE: MS. GINA MARIE WILLIAMS 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
1174400000XSpecialist4671027WI
2224Z00000XOccupational Therapy Assistant

General Provider Information

NPI Number : 1518195726
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GINA MARIE WILLIAMS COTA
Provider Business Mailing Address
First Line : JEWISH HOME AND CARE CENTER:THERAPY DEPARTMENT
Second Line : 1414 N PROSPECT AVE
City : MILWAUKEE
State : WI
Zip : 53202-3018
Country : US
Telephone Number : 414-277-8854
Fax Number : 844-284-6963
Provider Business Practice Location Address
First Line : JEWISH HOME AND CARE CENTER:THERAPY DEPARTMENT
Second Line : 1414 N PROSPECT AVE
City : MILWAUKEE
State : WI
Zip : 53202-3018
Country : US
Telephone Number : 414-277-8854
Fax Number : 844-284-6963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 01/22/2020

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