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General NPI Number Information
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NPI Number | 1205566296
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Entity Type | Individual
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Provider Name | MARK CHRISTOPHER SHARIK COTA
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Gender | Male
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 200 STOOPS DR
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City | MONONGAHELA
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State | PA
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Zip | 15063-3552
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Country | US
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Telephone | 724-310-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 110 EDGEWOOD DR
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City | NEW STANTON
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State | PA
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Zip | 15672-9795
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Country | US
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Telephone | 724-925-2160
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Fax |
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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 | OP007249
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License Number State | PA
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