MEDICARE: WILHELMINA AKPENE ANYIDOHO COTA/L

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	224Z00000X	Occupational Therapy Assistant	009000	NY

General Provider Information

NPI Number	:	1750883971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILHELMINA AKPENE ANYIDOHO COTA/L

Provider Business Mailing Address
First Line	:	15 MCBRIDE AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-3309
Country	:	US
Telephone Number	:	914-602-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	4102 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3008
Country	:	US
Telephone Number	:	718-547-0501
Fax Number	:

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

Provider Enumeration Date	:	03/03/2018
Last Update Date	:	03/03/2018

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