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General NPI Number Information
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NPI Number | 1255091245
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Entity Type | Individual
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Provider Name | MYROSLAV ZVERSHKHOVSKYY COTA
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Gender | Male
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Dates
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Enumeration Date | 12/18/2021
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 1771 N PIERCE ST APT 311
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City | ARLINGTON
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State | VA
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Zip | 22209-1830
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Country | US
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Telephone | 120-121-4738
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Fax |
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Provider Business Mailing Address
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Address Line | 1771 N PIERCE ST APT 311
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City | ARLINGTON
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State | VA
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Zip | 22209-1830
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Country | US
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Telephone | 120-121-4738
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131-002577
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License Number State | VA
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