Provider Demographics
NPI:1942692827
Name:FIGUEIREDO-DIAZ, MELISSA (COTA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FIGUEIREDO-DIAZ
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 1:4143 39TH PL
Mailing Address - Street 2:APT 3K
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-4218
Mailing Address - Country:US
Mailing Address - Phone:917-771-2949
Mailing Address - Fax:
Practice Address - Street 1:4143 39TH PL
Practice Address - Street 2:APT 3K
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-4218
Practice Address - Country:US
Practice Address - Phone:917-771-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008384224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant