Individual
DR. KAEDE OTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4353
(215) 707-2781
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-4353
(215) 707-2781
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
MD440444
PA
207ZM0300X
Medical Microbiology Physician
MD440444
PA
Other
Enumeration date
03/24/2016
Last updated
05/10/2016
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