Healthcare Provider Details

I. General information

NPI: 1306100581
Provider Name (Legal Business Name): TAFFI WILLIAMS COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 JUANITA CT
LEVITTOWN PA
19057-3632
US

IV. Provider business mailing address

271 JUANITA CT
LEVITTOWN PA
19057-3632
US

V. Phone/Fax

Practice location:
  • Phone: 215-740-2556
  • Fax:
Mailing address:
  • Phone: 215-740-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberOP007057
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberOP007057
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: