Healthcare Provider Details

I. General information

NPI: 1871398222
Provider Name (Legal Business Name): OLIVIA ZABACHTA COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 GROVE ST.
NEWTON MA
02466
US

IV. Provider business mailing address

29 UNDINE RD
BRIGHTON MA
02135-3811
US

V. Phone/Fax

Practice location:
  • Phone: 908-565-3281
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4523
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: