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NPI Code Detail

MEDICARE: ALENA OTERO PA

MEDICARE:   ALENA  OTERO  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantMA053010PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1232664784OTHERPATAX ID

General Provider Information

NPI Number : 1437336393
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALENA OTERO PA
Provider Business Mailing Address
First Line : 1700 WHITEHORSE HAMILTON SQUARE RD STE D1
Second Line :
City : HAMILTON SQUARE
State : NJ
Zip : 08690-3540
Country : US
Telephone Number : 609-890-2600
Fax Number : 609-890-1016
Provider Business Practice Location Address
First Line : 1700 WHITEHORSE HAMILTON SQUARE RD STE D1
Second Line :
City : HAMILTON SQUARE
State : NJ
Zip : 08690-3540
Country : US
Telephone Number : 609-890-2600
Fax Number : 609-890-1016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2008
Last Update Date : 03/19/2018

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Directions to “ ALENA OTERO PA” Practice Location

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