Provider Demographics
NPI:1477137313
Name:VARGA, YINETY (COTA)
Entity Type:Individual
Prefix:
First Name:YINETY
Middle Name:
Last Name:VARGA
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 1:704 BROOK AVE APT 5L
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-1386
Mailing Address - Country:US
Mailing Address - Phone:917-659-8923
Mailing Address - Fax:
Practice Address - Street 1:704 BROOK AVE APT 5L
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1386
Practice Address - Country:US
Practice Address - Phone:917-659-8923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010747-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant