MEDICARE: JESSICA A OTOO

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
1	183500000X	Pharmacist	PH1001232	MA

General Provider Information

NPI Number	:	1891671434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA A OTOO

Provider Business Mailing Address
First Line	:	74 ADAMS ST APT 4
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02453-4486
Country	:	US
Telephone Number	:	774-502-5769
Fax Number	:

Provider Business Practice Location Address
First Line	:	468 BLUE HILL AVE
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02121-4308
Country	:	US
Telephone Number	:	617-427-7806
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	08/11/2025

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Directions to “ JESSICA A OTOO ” Practice Location

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