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NPI Code Detail

MEDICARE: JOANN PHILLIPS COTA/L

MEDICARE:   JOANN  PHILLIPS  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
1225X00000XOccupational Therapist024013NY

General Provider Information

NPI Number : 1841729506
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANN PHILLIPS COTA/L
Provider Business Mailing Address
First Line : 93 WINTERS ST
Second Line :
City : BRONX
State : NY
Zip : 10464-1519
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 93 WINTERS ST
Second Line :
City : BRONX
State : NY
Zip : 10464-1519
Country : US
Telephone Number : 917-971-2423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2017
Last Update Date : 02/24/2020

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Directions to “ JOANN PHILLIPS COTA/L” Practice Location

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