Provider Demographics
NPI:1396862132
Name:CHARTORYSKY, CATHERINE (COTA)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:CHARTORYSKY
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:RR 9 BOX 9492
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-9238
Mailing Address - Country:US
Mailing Address - Phone:570-510-0491
Mailing Address - Fax:
Practice Address - Street 1:100 EDELLA RD
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1628
Practice Address - Country:US
Practice Address - Phone:570-586-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002678L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant