Provider Demographics
NPI:1013223486
Name:COST, ALLISON (MS, OTR-L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:COST
Suffix:
Gender:F
Credentials:MS, OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MANHATTAN AVE
Mailing Address - Street 2:APT 714
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5240
Mailing Address - Country:US
Mailing Address - Phone:210-686-5703
Mailing Address - Fax:
Practice Address - Street 1:100 MANHATTAN AVE
Practice Address - Street 2:APT 714
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5240
Practice Address - Country:US
Practice Address - Phone:210-686-5703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016069-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist