Healthcare Provider Details

I. General information

NPI: 1982274494
Provider Name (Legal Business Name): MONA SAAD COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6055 68TH RD APT 3
RIDGEWOOD NY
11385-5156
US

IV. Provider business mailing address

6055 68TH RD APT 3
RIDGEWOOD NY
11385-5156
US

V. Phone/Fax

Practice location:
  • Phone: 347-567-8362
  • Fax:
Mailing address:
  • Phone: 347-567-8362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number010559-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: