Provider Demographics
NPI:1093471260
Name:AMARO, MARTIN N/A (COTA)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:N/A
Last Name:AMARO
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 LOREWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-1417
Mailing Address - Country:US
Mailing Address - Phone:302-588-4984
Mailing Address - Fax:
Practice Address - Street 1:2507 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4841
Practice Address - Country:US
Practice Address - Phone:610-872-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU2-0012209224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant