Organization
DELORES JAMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES JAMES COTA (CERTIFIED OCCUPATIONAL THERAPY ASSI)
(718) 723-7586
Entity
Organization
Contact information
Practice address
24412 135TH AVE, ROSEDALE, NY 11422-1604
(718) 723-7586
Mailing address
24412 135TH AVE, ROSEDALE, NY 11422-1604
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
004196
NY
Other
Enumeration date
09/19/2015
Last updated
09/19/2015
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