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NPI Code Detail

MEDICARE: SHAQUAY LYNCH COTA

MEDICARE: SHAQUAY LYNCH 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 Assistant
2224Z00000XOccupational Therapy AssistantOP009667PA

General Provider Information

NPI Number : 1689303513
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAQUAY LYNCH COTA
Provider Business Mailing Address
First Line : 5639 PENTRIDGE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19143-4607
Country : US
Telephone Number : 267-269-0352
Fax Number :
Provider Business Practice Location Address
First Line : 43 CHURCH LN
Second Line :
City : BROOMALL
State : PA
Zip : 19008-2503
Country : US
Telephone Number : 954-210-8010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2022
Last Update Date : 01/11/2023

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Directions to “ SHAQUAY LYNCH COTA” Practice Location

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