Provider Demographics
NPI:1265676282
Name:COTAYO, MICHAEL J (MSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:COTAYO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W 26TH ST
Mailing Address - Street 2:8TH FLOOR OFFICE 25
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6700
Mailing Address - Country:US
Mailing Address - Phone:646-939-1997
Mailing Address - Fax:
Practice Address - Street 1:226 W 26TH ST
Practice Address - Street 2:8TH FLOOR OFFICE 25
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6700
Practice Address - Country:US
Practice Address - Phone:646-939-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0756341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03344282Medicaid
NY03344282Medicaid