Healthcare Provider Details

I. General information

NPI: 1134534043
Provider Name (Legal Business Name): CHEE TUNG YAP COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13425 FRANKLIN AVE APT 319
FLUSHING NY
11355-4654
US

IV. Provider business mailing address

13425 FRANKLIN AVE APT 319
FLUSHING NY
11355-4654
US

V. Phone/Fax

Practice location:
  • Phone: 646-546-2888
  • Fax:
Mailing address:
  • Phone: 646-546-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number008480
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: