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General NPI Number Information
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NPI Number | 1609308527
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Entity Type | Organization
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Legal Business Name | DR. VICTOR OTOKITI, PHYSICIAN, P.C.
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 7251 STATE ROUTE 104
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City | OSWEGO
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State | NY
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Zip | 13126-6029
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Country | US
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Telephone | 212-729-1804
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Fax |
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Provider Business Mailing Address
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Address Line | 7251 STATE ROUTE 104
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City | OSWEGO
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State | NY
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Zip | 13126-6029
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICTOR OTOKITI
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Credential |
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Telephone | 212-729-1804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2608251
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License Number State | NY
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