Individual
TAMMY OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,RN,CPN
Contact information
Practice address
87 WASHINGTON ST, RENSSELAER, NY 12144-2613
(518) 449-1142
(518) 449-1320
Mailing address
10 CHARL LN, TROY, NY 12180-9554
(513) 519-9272
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
831589
NY
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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