Individual
DR. NICOLE OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3535 MARKET ST, SUITE 100, PHILADELPHIA, PA 19104-3309
(215) 746-3535
(215) 746-1032
Mailing address
213 DICKINSON AVE, SWARTHMORE, PA 19081-1630
(610) 328-2892
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD425787
PA
Other
Enumeration date
11/06/2006
Last updated
09/09/2009
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