Most Relevant Information
Provider Data
| NPI Number: | 1003243569 |
| Provider Name: | AMANDA C HETHERINGTON COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 008175-1 |
Most Important Dates
| Enumeration Date: | 09/30/2013 |
| Last Updated: | 09/30/2013 |
Provider Practice Location
78 SOUTH RD
HOLMES
NY
125315320
Practice Location Phone/Fax
| Phone: | 9148198152 |
| Fax: |
Provider Mailing Location
78 SOUTH RD
HOLMES
NY
125315320
Provider Mailing Phone/Fax
| Phone: | 9148198152 |
| Fax: |