Healthcare Provider Details

I. General information

NPI: 1720265291
Provider Name (Legal Business Name): CYNTHIA BARBER COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 ROCKSIDE RD
INDEPENDENCE OH
44131-2199
US

IV. Provider business mailing address

245 KEHNER RD
MOGADORE OH
44260-9625
US

V. Phone/Fax

Practice location:
  • Phone: 216-901-0400
  • Fax:
Mailing address:
  • Phone: 330-612-3425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number03226
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: