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General NPI Number Information
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NPI Number | 1609386804
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Entity Type | Individual
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Provider Name | SAMANTHA DAGGETT COTA
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Gender | Female
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 10/03/2017
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Provider Practice Location Address
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Address Line | 1060 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10025-1715
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Country | US
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Telephone | 121-231-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 129 WISPERWOOD DR
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City | DINGMANS FERRY
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State | PA
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Zip | 18328-3461
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Country | US
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Telephone | 570-878-2459
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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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