Organization
CONNECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY BETH WITTE COTA (CERTIFIED OCCUPATIONAL THERAPY ASST)
(315) 935-5780
Entity
Organization
Contact information
Practice address
1744 W GENESEE ST, SYRACUSE, NY 13204-1902
(315) 468-3414
Mailing address
1744 W GENESEE ST, SYRACUSE, NY 13204-1902
(315) 468-3414
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
002309
NY
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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