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General NPI Number Information
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NPI Number | 1811474281
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Entity Type | Individual
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Provider Name | MARY A NAUGHTON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 1165 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1613
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Country | US
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Telephone | 732-246-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 56 GLENWOOD AVE APT 57
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City | JERSEY CITY
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State | NJ
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Zip | 07306-4621
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Country | US
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Telephone | 617-642-9204
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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 | 46TA09161500
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License Number State | NJ
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