Healthcare Provider Details

I. General information

NPI: 1346640802
Provider Name (Legal Business Name): AMANDA REED COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA TOTH

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 DIVISION ST
NORTH TONAWANDA NY
14120-4461
US

IV. Provider business mailing address

140 SOUTHCREST AVE
CHEEKTOWAGA NY
14225-3410
US

V. Phone/Fax

Practice location:
  • Phone: 716-692-1049
  • Fax:
Mailing address:
  • Phone: 716-563-7305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number008430
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: