Individual
BRANDON JAMES OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19 WEST AVE STE 103, SARATOGA SPRINGS, NY 12866-6052
(518) 583-0111
Mailing address
19 WEST AVE STE 103, SARATOGA SPRINGS, NY 12866-6052
(518) 583-0111
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
297545-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015002600
—
FL
Enumeration date
04/20/2009
Last updated
07/05/2019
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