MEDICARE: SOFIE KASATKIN COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	004527-1	NY

General Provider Information

NPI Number	:	1083984173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFIE KASATKIN COTA

Provider Business Mailing Address
First Line	:	1332 67TH ST
Second Line	:	APT. #7
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6196
Country	:	US
Telephone Number	:	917-609-2028
Fax Number	:

Provider Business Practice Location Address
First Line	:	1332 67TH ST
Second Line	:	APT. #7
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6196
Country	:	US
Telephone Number	:	917-609-2028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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