Provider Demographics
NPI:1285137570
Name:COTA, JOHN (PA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:COTA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SAINT NICHOLAS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4051
Mailing Address - Country:US
Mailing Address - Phone:718-821-0643
Mailing Address - Fax:888-732-7172
Practice Address - Street 1:129 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4051
Practice Address - Country:US
Practice Address - Phone:718-821-0643
Practice Address - Fax:888-732-7172
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPO9647207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology