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General NPI Number Information
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NPI Number | 1003294885
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Entity Type | Individual
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Provider Name | SHARON LEE WITTMEYER CROWLEY COTA
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Gender | Female
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 4757 ROUTE 305
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City | CUBA
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State | NY
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Zip | 14727-1491
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Country | US
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Telephone | 716-560-4005
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Fax | 585-968-0230
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Provider Business Mailing Address
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Address Line | 4757 ROUTE 305
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City | CUBA
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State | NY
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Zip | 14727-1491
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Country | US
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Telephone | 716-560-4005
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Fax | 585-968-0230
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 006638-1
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License Number State | NY
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