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NPI Code Detail

MEDICARE: STEPHANY JEAN BURZDAK COTA/L

MEDICARE: STEPHANY JEAN BURZDAK 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
1224Z00000XOccupational Therapy Assistant4529MA

General Provider Information

NPI Number : 1962042739
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANY JEAN BURZDAK COTA/L
Provider Business Mailing Address
First Line : 546 CHICOPEE ST
Second Line :
City : CHICOPEE
State : MA
Zip : 01013-2148
Country : US
Telephone Number : 413-536-2540
Fax Number : 413-536-3571
Provider Business Practice Location Address
First Line : 546 CHICOPEE ST
Second Line :
City : CHICOPEE
State : MA
Zip : 01013-2148
Country : US
Telephone Number : 413-536-2540
Fax Number : 413-536-3571
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2020
Last Update Date : 01/09/2020

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