Healthcare Provider Details

I. General information

NPI: 1073842639
Provider Name (Legal Business Name): ABIGAIL L COMEAU COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 BROOK RD CHILDREN'S HOSPITAL
RICHMOND VA
23220-1215
US

IV. Provider business mailing address

2924 BROOK RD CHILDREN'S HOSPITAL CREDENTIALING DEPT
RICHMOND VA
23220-1215
US

V. Phone/Fax

Practice location:
  • Phone: 804-321-7474
  • Fax: 804-228-5210
Mailing address:
  • Phone: 804-321-7474
  • Fax: 804-228-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: