Healthcare Provider Details

I. General information

NPI: 1467930636
Provider Name (Legal Business Name): DARRYL LYNN YUSKO COTA/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 CAPITOL HILL RD
DILLSBURG PA
17019-9742
US

IV. Provider business mailing address

212 CAPITOL HILL RD
DILLSBURG PA
17019-9742
US

V. Phone/Fax

Practice location:
  • Phone: 717-814-1973
  • Fax:
Mailing address:
  • Phone: 717-814-1973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License NumberOTA-001975L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberOTA001975L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA001975L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: