Healthcare Provider Details

I. General information

NPI: 1508200726
Provider Name (Legal Business Name): SCOTT BARNES COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 STATE ROUTE 55
NAPANOCH NY
12458-2740
US

IV. Provider business mailing address

12 STATE ROUTE 55
NAPANOCH NY
12458-2740
US

V. Phone/Fax

Practice location:
  • Phone: 845-210-4809
  • Fax:
Mailing address:
  • Phone: 845-210-4809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number008262
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: