Provider Demographics
NPI:1740428499
Name:BARRETT, PAULA VINCENZA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:VINCENZA
Last Name:BARRETT
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 1:20 FANCHER AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1711
Mailing Address - Country:US
Mailing Address - Phone:716-836-7591
Mailing Address - Fax:
Practice Address - Street 1:20 FANCHER AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-1711
Practice Address - Country:US
Practice Address - Phone:716-836-7591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000508-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant