Healthcare Provider Details

I. General information

NPI: 1477829869
Provider Name (Legal Business Name): CATHERINE LORDI CASH COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 HIGHWAY 35
HAZLET NJ
07730-1552
US

IV. Provider business mailing address

5 CLOVERHILL LN
FREEHOLD NJ
07728-8118
US

V. Phone/Fax

Practice location:
  • Phone: 732-264-5800
  • Fax:
Mailing address:
  • Phone: 732-409-6048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number46TA09084200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: