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NPI Code Detail

MEDICARE: JEANINE M KUPER COTA

MEDICARE: JEANINE M KUPER 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 Assistant536NH

General Provider Information

NPI Number : 1649304916
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANINE M KUPER COTA
Provider Business Mailing Address
First Line : 37 BIRCHWOOD CIR
Second Line :
City : BEDFORD
State : NH
Zip : 03110-4911
Country : US
Telephone Number : 603-472-3901
Fax Number :
Provider Business Practice Location Address
First Line : 29 CENTER ST
Second Line :
City : GOFFSTOWN
State : NH
Zip : 03045-2948
Country : US
Telephone Number : 603-497-4128
Fax Number : 603-497-4085
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ JEANINE M KUPER COTA” Practice Location

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