Healthcare Provider Details

I. General information

NPI: 1700079878
Provider Name (Legal Business Name): TAMMY A. STRUNK COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WASHINGTON STREET
COLUMBIA NJ
07832
US

IV. Provider business mailing address

2222 SULLIVAN TRL
EASTON PA
18040-7958
US

V. Phone/Fax

Practice location:
  • Phone: 908-459-4128
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number46TA09029700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: