Provider Demographics
NPI:1477862035
Name:MILLIGAN, ALISON B (COTA)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:B
Last Name:MILLIGAN
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 1:14 WILLIS ST
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1964
Mailing Address - Country:US
Mailing Address - Phone:631-757-1107
Mailing Address - Fax:631-757-2226
Practice Address - Street 1:14 WILLIS ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1964
Practice Address - Country:US
Practice Address - Phone:631-757-1107
Practice Address - Fax:631-757-2226
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004877-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant