Provider Demographics
NPI:1396045480
Name:MARTIN, JAMES FRANK (COTA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FRANK
Last Name:MARTIN
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 1:111 LIME KILN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-2601
Mailing Address - Country:US
Mailing Address - Phone:845-354-4625
Mailing Address - Fax:
Practice Address - Street 1:111 LIME KILN RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-2601
Practice Address - Country:US
Practice Address - Phone:845-354-4625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-24
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09014600224Z00000X
NY004776224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant