1598065179 NPI number — MISS DIANE MARIE DILLABOUGH COTA

Table of content: MISS DIANE MARIE DILLABOUGH COTA (NPI 1598065179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598065179 NPI number — MISS DIANE MARIE DILLABOUGH COTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DILLABOUGH
Provider First Name:
DIANE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
COTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598065179
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BOX 70 MIDDLE SETTLEMENT RD.
Provider Second Line Business Mailing Address:
ONEIDA HERKIMER MADISON BOCES
Provider Business Mailing Address City Name:
NEW HARTFORD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13413-0070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-793-8525
Provider Business Mailing Address Fax Number:
315-223-4748

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5176 ST ROUTE 233
Provider Second Line Business Practice Location Address:
WESTMORELAND ELEMETARY SCHOOL
Provider Business Practice Location Address City Name:
WESTMORELAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-793-8525
Provider Business Practice Location Address Fax Number:
315-223-4748
Provider Enumeration Date:
10/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 224Z00000X , with the licence number:  003399-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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