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NPI Code Detail

MEDICARE: JASON SCOTT MASK COTA

MEDICARE: JASON SCOTT MASK 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
1224Z00000XOccupational Therapy Assistant0131002059VA

General Provider Information

NPI Number : 1700651882
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON SCOTT MASK COTA
Provider Business Mailing Address
First Line : 2014 CYPRESS DR
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22911-5825
Country : US
Telephone Number : 970-623-9900
Fax Number :
Provider Business Practice Location Address
First Line : 2400 MCKINNEY BLVD
Second Line :
City : COLONIAL BEACH
State : VA
Zip : 22443-1237
Country : US
Telephone Number : 804-224-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 11/20/2023

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