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General NPI Number Information
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NPI Number | 1225572332
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Entity Type | Individual
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Provider Name | CHRISTINA JEAN DONATACCIO COTA/L
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Gender | Female
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 236 2ND AVE SUIT 401
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City | NEW YORK
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State | NY
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Zip | 10003-2704
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Country | US
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Telephone | 212-683-8905
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Fax | 212-683-8906
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Provider Business Mailing Address
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Address Line | 1447 BROADWAY 2L
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City | ASTORIA
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State | NY
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Zip | 11106-4529
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Country | US
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Telephone | 727-534-8684
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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 | 009156-1
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License Number State | NY
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