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General NPI Number Information
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NPI Number | 1386019768
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Entity Type | Individual
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Provider Name | BARBARA DZIEDZIC COTA
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Gender | Female
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Dates
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Enumeration Date | 12/10/2015
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 43 LIBERTY DR
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City | AMSTERDAM
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State | NY
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Zip | 12010-5635
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Country | US
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Telephone | 518-954-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 125 2ND AVE E
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City | FONDA
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State | NY
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Zip | 12068-5024
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Country | US
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Telephone | 518-829-5266
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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 | 002627-1
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License Number State | NY
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