Healthcare Provider Details

I. General information

NPI: 1619889318
Provider Name (Legal Business Name): SUSAN RODRIGUES COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUSAN TAPPAN

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 GERSTEIN ST
CROTON ON HUDSON NY
10520-2419
US

IV. Provider business mailing address

2 HEIDI LN
CHESTER NY
10918-4725
US

V. Phone/Fax

Practice location:
  • Phone: 914-271-5184
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number011842-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: