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NPI Code Detail

MEDICARE: MS. HEATHER SARAH KENNEDY COTA

MEDICARE: MS. HEATHER SARAH KENNEDY 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
1224Z00000XOccupational Therapy Assistant008074NY

General Provider Information

NPI Number : 1154693802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER SARAH KENNEDY COTA
Provider Business Mailing Address
First Line : 4885 ROUTE 9
Second Line : P.O. BOX 367
City : STAATSBURG
State : NY
Zip : 12580-6028
Country : US
Telephone Number : 845-889-9599
Fax Number :
Provider Business Practice Location Address
First Line : 4885 ROUTE 9
Second Line :
City : STAATSBURG
State : NY
Zip : 12580-6028
Country : US
Telephone Number : 845-889-9599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2012
Last Update Date : 01/27/2012

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Directions to “ MS. HEATHER SARAH KENNEDY COTA” Practice Location

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