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NPI Code Detail

MEDICARE: MS. LISA HARE COTAL

MEDICARE: MS. LISA HARE COTAL
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 AssistantOP001330LPA

General Provider Information

NPI Number : 1598880221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA HARE COTAL
Provider Business Mailing Address
First Line : 558 E WOODLAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19144-1316
Country : US
Telephone Number : 610-905-6896
Fax Number :
Provider Business Practice Location Address
First Line : 8015 LAWNDALE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-1507
Country : US
Telephone Number : 215-725-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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