Healthcare Provider Details

I. General information

NPI: 1770884777
Provider Name (Legal Business Name): LORRAINE MCGINN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORRAINE ENGELHART

II. Dates (important events)

Enumeration Date: 11/06/2010
Last Update Date: 11/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 S WOODS RD
WOODBURY NY
11797-1024
US

IV. Provider business mailing address

38 EDWARDS PL
HUNTINGTN STA NY
11746-1014
US

V. Phone/Fax

Practice location:
  • Phone: 516-921-7650
  • Fax: 516-364-4258
Mailing address:
  • Phone: 631-219-5291
  • Fax: 631-351-1216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number005844-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: