Basic Information
| Provider Information | |||||||||
| NPI: | 1376810234 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | POTO | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 BLUE MILL RD | ||||||||
| Address2: | |||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079606714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738963874 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1940 COMMERCE STREET, SUITE 210 | ||||||||
| Address2: | PRIME REHABILITATION SERVICES, INCORPORATED | ||||||||
| City: | YORKTOWN HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146319020 | ||||||||
| FaxNumber: | 9146319028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2011 | ||||||||
| LastUpdateDate: | 11/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 46TA09043400 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.