Provider Demographics
NPI:1457090243
Name:ANDRADE, SOPHIA ALEXANDRA (COTA)
Entity Type:Individual
Prefix:MS
First Name:SOPHIA
Middle Name:ALEXANDRA
Last Name:ANDRADE
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 1:144 YULAN BARRYVILLE RD APT 2
Mailing Address - Street 2:
Mailing Address - City:BARRYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12719-5230
Mailing Address - Country:US
Mailing Address - Phone:845-649-2378
Mailing Address - Fax:
Practice Address - Street 1:4806 NY-52
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12748
Practice Address - Country:US
Practice Address - Phone:845-482-4375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant