Individual
RACHID OTTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
(718) 667-2300
Mailing address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NYCPS-P-705
NY
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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