Provider Demographics
NPI:1609007681
Name:MOTOLA, SHERRY L (OTA)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:MOTOLA
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:BULLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10915-0099
Mailing Address - Country:US
Mailing Address - Phone:845-800-4888
Mailing Address - Fax:
Practice Address - Street 1:2 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917-4006
Practice Address - Country:US
Practice Address - Phone:845-928-9780
Practice Address - Fax:845-928-6209
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003699-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant