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NPI Code Detail

MEDICARE: SYDNEY MANNING COTA

MEDICARE: SYDNEY MANNING 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
1174400000XSpecialist356805NY

General Provider Information

NPI Number : 1427412915
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY MANNING COTA
Provider Business Mailing Address
First Line : 400 MCCHESNEY AVE EXT
Second Line : 21-12
City : TROY
State : NY
Zip : 12180-8801
Country : US
Telephone Number : 518-338-8985
Fax Number :
Provider Business Practice Location Address
First Line : 673 COLUMBIA TPKE
Second Line :
City : EAST GREENBUSH
State : NY
Zip : 12061-2130
Country : US
Telephone Number : 518-233-0544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2016
Last Update Date : 10/30/2018

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