Provider Demographics
NPI:1487908604
Name:CARLINO, SANDRA MARIE (COTA)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIE
Last Name:CARLINO
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 1:208 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1331
Mailing Address - Country:US
Mailing Address - Phone:914-805-0820
Mailing Address - Fax:
Practice Address - Street 1:10 WEATHERVANE DR
Practice Address - Street 2:
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-2242
Practice Address - Country:US
Practice Address - Phone:845-496-1966
Practice Address - Fax:845-496-1976
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007903-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant