Individual
JANE OTTAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
6143 186TH ST, FRESH MEADOWS, NY 11365-2710
(718) 671-2100
Mailing address
300 CADMAN PLZ W, BROOKLYN, NY 11201-3229
(866) 277-9071
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
633584
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405124
NY
Other
Enumeration date
06/18/2012
Last updated
04/09/2026
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