Healthcare Provider Details

I. General information

NPI: 1164234076
Provider Name (Legal Business Name): HOLLY ZIENKOWICZ COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 COURT ST STE 3
CROMWELL CT
06416-1273
US

IV. Provider business mailing address

49 MELLOR RD
WALLINGFORD CT
06492-4954
US

V. Phone/Fax

Practice location:
  • Phone: 860-613-9930
  • Fax: 860-613-9952
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number001960
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: