Healthcare Provider Details

I. General information

NPI: 1982856597
Provider Name (Legal Business Name): DANIEL DENNIS ZIPAY JR. COTA/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 N CHARLOTTE ST
POTTSTOWN PA
19464-4607
US

IV. Provider business mailing address

724 N CHARLOTTE ST
POTTSTOWN PA
19464-4607
US

V. Phone/Fax

Practice location:
  • Phone: 610-323-1837
  • Fax:
Mailing address:
  • Phone: 610-323-1837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOP001856L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: