Individual
CARLOS OTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 50TH ST, NORTH BERGEN, NJ 07047-3118
(305) 562-6274
Mailing address
1300 50TH ST, NORTH BERGEN, NJ 07047-3118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407201189
NPI
NJ
Enumeration date
09/30/2021
Last updated
09/30/2021
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