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NPI Code Detail

MEDICARE: ANNA MARIE KOTANSKY OTL/R

MEDICARE: ANNA MARIE KOTANSKY OTL/R
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
1225X00000XOccupational TherapistOT012115OH

General Provider Information

NPI Number : 1265167662
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MARIE KOTANSKY OTL/R
Provider Business Mailing Address
First Line : 1471 WINTON AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3611
Country : US
Telephone Number : 216-870-3825
Fax Number :
Provider Business Practice Location Address
First Line : 1810 W 25TH ST UNIT 1
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3184
Country : US
Telephone Number : 216-685-9975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2022
Last Update Date : 07/19/2022

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