Provider Demographics
NPI:1053889162
Name:CHAPPETTA, ROBERT (COTA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CHAPPETTA
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 15TH ST NW APT 311
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-2909
Mailing Address - Country:US
Mailing Address - Phone:202-744-5682
Mailing Address - Fax:
Practice Address - Street 1:5721 GROSVENOR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1833
Practice Address - Country:US
Practice Address - Phone:301-530-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02546224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant