MEDICARE: MR. FRANC IVAN FRANCISCO COTA/L

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	010774	NY

General Provider Information

NPI Number	:	1255052890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANC IVAN FRANCISCO COTA/L

Provider Business Mailing Address
First Line	:	90 FERRIS AVE APT 3A
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-3428
Country	:	US
Telephone Number	:	914-469-0975
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 THROGGS NECK EXPY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2319
Country	:	US
Telephone Number	:	914-469-0975
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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