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General NPI Number Information
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NPI Number | 1184000671
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Entity Type | Individual
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Provider Name | JEANNE BORROMEO-OTTY LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 40 COLVIN AVE FL 2
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City | ALBANY
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State | NY
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Zip | 12206-1104
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Country | US
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Telephone | 518-605-7302
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Fax |
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Provider Business Mailing Address
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Address Line | 1362 STATE ROUTE 143
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City | COEYMANS HOLLOW
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State | NY
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Zip | 12046-2106
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Country | US
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Telephone | 518-755-6424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 079797
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License Number State | NY
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