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General NPI Number Information
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NPI Number | 1346295946
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Entity Type | Individual
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Provider Name | FREDERICK MICHAEL DILL COTA
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 125 MUNROE AVE
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City | W KEANSBURG
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State | NJ
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Zip | 07734-3027
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Country | US
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Telephone | 732-495-4595
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Fax |
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Provider Business Mailing Address
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Address Line | 125 MUNRO AVE
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City | W KEANSBURG
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State | NJ
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Zip | 07734-3027
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Country | US
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Telephone | 732-495-4595
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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 | NJ
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