Healthcare Provider Details

I. General information

NPI: 1043416514
Provider Name (Legal Business Name): LAURA ANNE CIFFA COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E NORTH ST
BUFFALO NY
14203-1002
US

IV. Provider business mailing address

719 MOORE AVE
BUFFALO NY
14223-1845
US

V. Phone/Fax

Practice location:
  • Phone: 716-885-8871
  • Fax:
Mailing address:
  • Phone: 716-885-8871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number004856-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: