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NPI Code Detail

MEDICARE: MS. CAROL LEE LAFAUCI COTA

MEDICARE: MS. CAROL LEE LAFAUCI 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
1314000000XSkilled Nursing Facility000570CT

General Provider Information

NPI Number : 1528285152
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL LEE LAFAUCI COTA
Provider Business Mailing Address
First Line : 53 BRONSON RD
Second Line : POB 7145
City : PROSPECT
State : CT
Zip : 06712-1000
Country : US
Telephone Number : 203-758-0230
Fax Number :
Provider Business Practice Location Address
First Line : 245 LONG HILL RD
Second Line :
City : MIDDLETOWN
State : CT
Zip : 06457-4063
Country : US
Telephone Number : 866-552-9292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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