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NPI Code Detail

MEDICARE: MRS. CYNTHIA MARIE KUBIS COTA

MEDICARE: MRS. CYNTHIA MARIE KUBIS 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 Assistant19-027WI
2314000000XSkilled Nursing Facility19-027WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336312214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA MARIE KUBIS COTA
Provider Business Mailing Address
First Line : 5700 W LAYTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4016
Country : US
Telephone Number : 414-325-4069
Fax Number :
Provider Business Practice Location Address
First Line : 5700 W LAYTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4016
Country : US
Telephone Number : 414-325-4069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2008
Last Update Date : 04/11/2008

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