# H. GREGORY OTA, M.D., P.C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033491766
- **Authorized official:** H GREGORY OTA M.D. (PRESIDENT)
- **Authorized official phone:** (781) 874-1965

## Contact information

- **Practice address:** 101 MAIN ST, SUITE 216, MEDFORD, MA 02155-4540
- **Practice address phone:** (781) 874-1965
- **Practice address fax:** (781) 874-1967
- **Mailing address:** 101 MAIN ST, SUITE 216, MEDFORD, MA 02155-4540
- **Mailing address phone:** (781) 874-1965
- **Mailing address fax:** (781) 874-1967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 54244 | MA | Yes |

## Other

- **Enumeration date:** 09/20/2011
- **Last updated:** 09/20/2011