Provider Demographics
NPI:1114441938
Name:ROWE, PATRICE ANDREA (COTA)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:ANDREA
Last Name:ROWE
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 1:675 E 170TH ST APT 3D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2345
Mailing Address - Country:US
Mailing Address - Phone:646-597-1639
Mailing Address - Fax:
Practice Address - Street 1:1880 BRYANT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5110
Practice Address - Country:US
Practice Address - Phone:347-291-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008419-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant