Provider Demographics
NPI:1144436890
Name:COTTO, ISAAC (MSW)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:COTTO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 12636
Mailing Address - Street 2:BO BUCARABONES
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9728
Mailing Address - Country:US
Mailing Address - Phone:787-479-7047
Mailing Address - Fax:
Practice Address - Street 1:HOSP PSIQUIATRIA DR RAMON FERNANDEZ MARINA
Practice Address - Street 2:BO MONACILLO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922
Practice Address - Country:US
Practice Address - Phone:787-766-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical