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NPI Code Detail

MEDICARE: MRS. MELISSA EDLER COTA/L

MEDICARE: MRS. MELISSA EDLER 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
1224Z00000XOccupational Therapy AssistantOP007480PA

General Provider Information

NPI Number : 1831605526
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA EDLER COTA/L
Provider Business Mailing Address
First Line : 114 WILLIAMS LN
Second Line :
City : JERSEY SHORE
State : PA
Zip : 17740-8219
Country : US
Telephone Number : 570-398-4894
Fax Number :
Provider Business Practice Location Address
First Line : 2140 WARRENSVILLE RD
Second Line :
City : MONTOURSVILLE
State : PA
Zip : 17754-9621
Country : US
Telephone Number : 570-433-3161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2017
Last Update Date : 12/18/2017

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