Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 165369 | NY |
N | 207VG0400X | Gynecologist | 165369 | NY |
N | 207VX0000X | Obstetrician | 165369 | NY |
NPI | 1023195419 |
---|---|
Provider Name | Allen Ott |
First Address | Southampton, NY 11968-3004 |
Second Address | Southampton, NY 11968-3004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 31/08/2009 |