Healthcare Provider Details

I. General information

NPI: 1205280831
Provider Name (Legal Business Name): MARILYN IACOVIELLO COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S HARRISON ST APT 20H
EAST ORANGE NJ
07018-1335
US

IV. Provider business mailing address

320 S HARRISON ST APT 20H
EAST ORANGE NJ
07018-1335
US

V. Phone/Fax

Practice location:
  • Phone: 973-223-2950
  • Fax:
Mailing address:
  • Phone: 973-223-2950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number46TA09129700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: