MEDICARE: MARGARET BROBBEY 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
1	174400000X	Specialist	007528-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	007528-1	OTHER	NY	COTA LICENSE

General Provider Information

NPI Number	:	1588967293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET BROBBEY COTA

Provider Business Mailing Address
First Line	:	140 ELGAR PL
Second Line	:	APARTMENT #19E
City	:	BRONX
State	:	NY
Zip	:	10475-5201
Country	:	US
Telephone Number	:	212-866-0666
Fax Number	:	212-866-2036

Provider Business Practice Location Address
First Line	:	140 ELGAR PL
Second Line	:	APARTMENT #19E
City	:	BRONX
State	:	NY
Zip	:	10475-5201
Country	:	US
Telephone Number	:	212-866-0666
Fax Number	:	212-866-2036

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

Provider Enumeration Date	:	12/20/2010
Last Update Date	:	12/20/2010

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Directions to “ MARGARET BROBBEY COTA” Practice Location

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