Healthcare Provider Details

I. General information

NPI: 1235076563
Provider Name (Legal Business Name): BONNIE MCKEOWN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2995 CURRY RD EXT
SCHENECTADY NY
12303-2801
US

IV. Provider business mailing address

2995 CURRY RD EXT
SCHENECTADY NY
12303-2801
US

V. Phone/Fax

Practice location:
  • Phone: 518-836-2221
  • Fax:
Mailing address:
  • Phone: 518-835-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number001260-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: