NPI Code Detail JSON Logo

1639640139 NPI number — ERICA LYNN ROSELLI COTA/L

NPI Number: 1639640139
Health Care Provider/Practitioner: ERICA LYNN ROSELLI COTA/L

Information about “1639640139” NPI (ERICA LYNN ROSELLI COTA/L) exists in 1639640139 in HTML format HTML  |  1639640139 in plain Text format TXT  |  1639640139 in PDF (Portable Document Format) PDF  |  1639640139 in an XML format XML  formats.

NPI Number : 1639640139 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639640139",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROSELLI",
    "FirstName": "ERICA",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "COTA/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1418 S BROAD ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHILADELPHIA",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19146-4808",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "484-947-1347",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1194 NAAMANS CREEK RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GARNET VALLEY",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19060-1615",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "610-558-7840",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/09/2018",
    "LastUpdateDate": "12/09/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "224Z00000X",
        "TaxonomyName": "Occupational Therapy Assistant",
        "LicenseNumber": "OP009526",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.