Individual
DR. ANITA OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5030 STATE ROAD, SUITE 2-400, DREXEL HILL, PA 19026-4605
(610) 394-1365
(610) 394-1368
Mailing address
5030 STATE ROAD, SUITE 2-400, DREXEL HILL, PA 19026
(610) 394-1365
(610) 394-1368
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS008470L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001856710
—
PA
Enumeration date
11/17/2006
Last updated
04/22/2014
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