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NPI Code Detail

MEDICARE: SUSAN PATRICIA SABO COTA

MEDICARE: SUSAN PATRICIA SABO 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 AssistantOA2019ME

General Provider Information

NPI Number : 1932365467
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN PATRICIA SABO COTA
Provider Business Mailing Address
First Line : 1133 WASHINGTON AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04103-3629
Country : US
Telephone Number : 207-797-0600
Fax Number : 207-797-8659
Provider Business Practice Location Address
First Line : 1133 WASHINGTON AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04103-3629
Country : US
Telephone Number : 207-797-0600
Fax Number : 207-797-8659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2008
Last Update Date : 08/04/2008

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Directions to “ SUSAN PATRICIA SABO COTA” Practice Location

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