Provider Demographics
NPI:1487026613
Name:ROHIT, LILWANTIE TINA (COTA)
Entity type:Individual
Prefix:MS
First Name:LILWANTIE
Middle Name:TINA
Last Name:ROHIT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11417 123RD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2024
Mailing Address - Country:US
Mailing Address - Phone:718-835-4269
Mailing Address - Fax:
Practice Address - Street 1:11417 123RD ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2024
Practice Address - Country:US
Practice Address - Phone:718-835-4269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004534-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant