Provider Demographics
NPI:1619424736
Name:KONE, OLAWUNMI (COTA)
Entity Type:Individual
Prefix:MS
First Name:OLAWUNMI
Middle Name:
Last Name:KONE
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 1:1224 WALTON AVE
Mailing Address - Street 2:APT. 4A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-8000
Mailing Address - Country:US
Mailing Address - Phone:718-410-0298
Mailing Address - Fax:
Practice Address - Street 1:1224 WALTON AVE
Practice Address - Street 2:APT. 4A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-8000
Practice Address - Country:US
Practice Address - Phone:718-410-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003357-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY003357-1OtherNEW YORK STATE LICENSE