Provider Demographics
NPI:1255878161
Name:COTTER, JOSEPH E
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:COTTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 WICKHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6444
Mailing Address - Country:US
Mailing Address - Phone:917-825-7738
Mailing Address - Fax:
Practice Address - Street 1:2209 WICKHAM AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6444
Practice Address - Country:US
Practice Address - Phone:917-825-7738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist