Provider Demographics
NPI:1508200726
Name:BARNES, SCOTT (COTA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:BARNES
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 1:12 STATE ROUTE 55
Mailing Address - Street 2:
Mailing Address - City:NAPANOCH
Mailing Address - State:NY
Mailing Address - Zip Code:12458-2740
Mailing Address - Country:US
Mailing Address - Phone:845-210-4809
Mailing Address - Fax:
Practice Address - Street 1:12 STATE ROUTE 55
Practice Address - Street 2:
Practice Address - City:NAPANOCH
Practice Address - State:NY
Practice Address - Zip Code:12458-2740
Practice Address - Country:US
Practice Address - Phone:845-210-4809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008262224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant