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General NPI Number Information
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NPI Number | 1609349604
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Entity Type | Individual
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Provider Name | ABRAM WAUGH COTA
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Gender | Male
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 1818 NEWTON ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010-1017
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Country | US
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Telephone | 202-328-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 COLUMBIA PIKE APT 209
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City | ARLINGTON
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State | VA
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Zip | 22204-4528
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Country | US
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Telephone | 201-917-8883
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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 | OTA100000318
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License Number State | DC
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